Groin Pain Main
Introduction
Approach to Patients with Groin Pain
- The complexity of the anatomy makes it difficult to localize the pain.
- It can be very difficult to diagnose and treat
- There have been many different terms to describe sports-related groin pain:
- Sports Hernia
- Gilmore’s groin
- Athletic pubalgia
- Athletic groin pain
- Biomechanical groin overload
- Hockey-goalie syndrome
- Hockey groin
- Sports groin
- Sportsman's groin
- Sportsman's hernia
- A detailed clinical and radiological assessment of groin pain is critical and can identify underlying pathology
Epidemiology
- Groin injuries account for 2-5% of all sports-related injuries[5]
- Recurrence rate is high, between 15% and 31%
- Consists of area where the abdomen meets the legs, includes structures of the perineum
- Anatomic boundaries
- Superiorly: inguinal ligament
- Medially: lateral border of the rectus abdominis muscle
- Laterally: iliopsoas muscle
- Inferiorly: superior pubic ramus, Cooper's ligament
- Many non-musculoskeletal conditions can present with groin pain including gynaecological, urological, malignancies, sexually transmitted diseases and rheumatological conditions[6]
Differential Diagnosis
- Intra-articular / Hip Etiology
- Extra-articular Causes
- Pelvic Stress Fracture
- Osteitis Pubis
- Sports Hernia (Athletic Pubalgia)
- Avulsion Fractures of the Pelvis
- Snapping Hip Syndrome
- Iliopsoas Tendinopathy
- Rectus Femoris Strain
- Rectus Abdominal Strain
- Myositis Ossificans
- Iliac Apophysitis (AIIS, ASIS, Iliac Crest)
- Inguinal Hernia
- Femoral Hernia
- Adductor Tendonitis
- Adductor Strain
- Neuropathic/ Nerve Entrapment Syndromes
- Obturator Neuropathy
- Femoral Neuropathy
- Iliohypogastric Nerve Injury
- Genitofemoral Nerve Injury
- Ilioinguinal Nerve Injury
- Meralgia Paresthetica (Lateral Femoral Cutaneous Nerve)
- Pudendal Neuralgia
- Axial/Spinal Etiology
- Pediatric Considerations
- Intra-abdominal Considerations
- Abdominal Aortic Aneurysm
- Appendicitis
- Diverticulitis/ Diverticulosis
- Lymphadenitis
- Inflammatory Bowel Disease
- Genitourinary Considerations
- Ovarian/Testicular Torsion
- Ectopic Pregnancy
- Nephrolithiasis
- Epididymo-Orchitis
- Ovarian Cyst
- Pelvic Inflammatory Disease
- Round ligament pain
- Urinary Tract Infection
- Endometriosis
- Prostatitis
- Testicular cancer
See Also
References
- ↑ Tak, Igor JR. "Hip and groin pain in athletes: morphology, function and injury from a clinical perspective." British journal of sports medicine (2018).
- ↑ Pozzoli, Alberto, et al. "Percutaneous venous cannulation for minimally invasive cardiac surgery: the safest and effective technique described step-by-step." Frontiers in Surgery 9 (2022): 828772.
- ↑ Rolph, Rachel, et al. "Groin pain in athletes." bmj 368 (2020).
- ↑ Shanthanna, Harsha. "Successful treatment of genitofemoral neuralgia using ultrasound guided injection: a case report and short review of literature." Case reports in anesthesiology 2014.1 (2014): 371703.
- ↑ Werner, Jairo, et al. "UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons." British journal of sports medicine 43.13 (2009): 1036-1040.
- ↑ Bradshaw, Christopher J., Michael Bundy, and Eanna Falvey. "The diagnosis of longstanding groin pain: a prospective clinical cohort study." British journal of sports medicine 42.10 (2008): 851-854.