Idiopathic Pubic Symphysis Diastasis in a Patient With Autosomal Dominant Polycystic Kidney Disease: A Rare Case Report

Pubic symphysis diastasis (PSD) is characterized by widening of the pubic symphysis, most often associated with pregnancy, childbirth, or trauma, while idiopathic PSD is exceedingly rare. Autosomal dominant polycystic kidney disease (ADPKD) is a multisystem disorder, but PSD has not been previously reported in this context. We present a 22-year-old female with ADPKD and progressive hip discomfort and clicking since childhood. Examination revealed mildly restricted, painful hip motion without instability. Radiography showed a pubic symphysis width of 25.5 mm, with no sacroiliac, traumatic, or degenerative findings. With no obstetric, traumatic, or inflammatory history, idiopathic PSD was diagnosed. The patient was managed conservatively with physical therapy, activity modification, and orthopedic follow-up. This is the first reported case of idiopathic PSD in an ADPKD patient, expanding the spectrum of musculoskeletal manifestations in ADPKD and highlighting the need to consider pelvic structural disorders in unexplained hip or pelvic pain.