75 y female presented with pain in groin area over pubic symphysis as her only symptom. Exacerbated when she goes from reclining to sitting position and too painful to run on treadmill. Pressure if she walks any distance. No fever, diarrhea, constipation.

She has a BMI of 18. Runs on treadmill 3 miles 7 days/wk at rate of 5 mph. Eats one meal a day at dinner time in an effort to maintain low weight.

CT report: “early, acute diverticulitis.” Doctor prescribed course of Flagyl and another antibiotic. Told patient she could use treadmill as tolerated.

My question: Should pubic ramus stress fracture be ruled out with MRI. Doctor told patient if not improved with antibiotics within 5 days, probably a muscle strain. should inguinal hernia be ruled out- she has had one previously repaired.