Skip to main content

Advertisement

SpringerLink
Log in

Imaging assessment of groin pain

  • Review
  • Published:
MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Groin pain is a common condition in athletes, especially those who play certain sports, for instance soccer, ice hockey, fencing which request rapid acceleration and frequent changes of movement. This condition represents a diagnostic difficulty for the radiologist due to either the anatomical pubic region complexity than the many causes that can be a source of pain, because the groin pain can be determined by conditions affecting the bony structures, cartilage and muscle tendons that are part of the proper pubis but also from those involving the hip. The approach to the groin trough diagnostic imaging is multidisciplinary: The study of the patient is performed by traditional radiographs, ultrasound examination, magnetic resonance imaging or computed tomography, based on clinical suspicion, and each of these methods provides different results depending on the disease in question. The purpose of this article is to examine what are the optimal imaging techniques to investigate the various diseases affecting the patient with groin pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

  1. McMahon PJ, Hodnett PA, Koulouris GC, Eustace SJ, Kavanagh EC (2010) Hip and groin pain: radiological assessment. Open Sports Med J 4:108–120

    Google Scholar 

  2. Omar IM, Zoga AC, Kavanagh EC, Koulouris G, Bergin D, Gopez AG, Morrison WB, Meyers WC (2008) Athletic pubalgia and “sports hernia”: optimal MR imaging technique and findings. Radiographics 28:1415–1438

    Article  PubMed  Google Scholar 

  3. Robinson P, Barron DA, Parsons W, Grainger AJ, Schilders EM, O’Connor PJ (2004) Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings. Skeletal Radiol 33:451–457

    Article  PubMed  CAS  Google Scholar 

  4. Koulouris G (2008) Imaging review of groin pain in elite athletes: an anatomic approach to imaging findings. Am J Roentgenol 191:962–972

    Article  Google Scholar 

  5. Koval KJ, Aharonoff GB, Schwartz MC, Alpert S, Cohen G, McShinawy A, Zuckerman JD (1997) Pubic rami fracture: a benign pelvic injury? J Orthop Trauma 11:7–9

    Article  PubMed  CAS  Google Scholar 

  6. Balconi G (2011) US in pubalgia. J Ultrasound 14:157–166

    Article  PubMed  Google Scholar 

  7. De Paulis F, Cacchio A, Michelini O, Damiani A, Saggini R (1998) Sports injuries in the pelvis and hip: diagnostic imaging. Eur J Radiol 27(Suppl 1):S49–S59

    Article  PubMed  Google Scholar 

  8. Fon LJ, Spence RA (2000) Sportsman’s hernia. Br J Surg 87:545–552

    Article  PubMed  CAS  Google Scholar 

  9. Farber AJ, Wilckens JH (2007) Sports hernia: diagnosis and therapeutic approach. J Am Acad Orthop Surg 15:507–514

    PubMed  Google Scholar 

  10. Leander P, Ekberg O, Sjoberg S, Kesek P (2000) MR imaging following herniography in patients with unclear groin pain. Eur Radiol 10:1691–1696

    Article  PubMed  CAS  Google Scholar 

  11. Cappabianca S, Reginelli A, Iacobellis F, Granata V, Urciuoli L, Alabiso ME, Di Grezia G, Marano I, Gatta G, Grassi R (2011) Dynamic MRI defecography vs. entero-colpo-cysto-defecography in the evaluation of midline pelvic floor hernias in female pelvic floor disorders. Int J Colorectal Dis 26(9):1191–1196

    Article  PubMed  Google Scholar 

  12. Grassi R, Lombardi G, Reginelli A, Capasso F, Romano F, Floriani I, Colacurci N (2007) Coccygeal movement: assessment with dynamic MRI. Eur J Radiol 61(3):473–479

    Article  PubMed  Google Scholar 

  13. Nappi C, Greco E, Anichini C, Guerra G, Di Spiezio Sardo A (2008) Pregnancy in a gerodermia osteodysplastica patient: a case report. Am J Obstet Gynecol 198(1):e17–e19

    Article  PubMed  Google Scholar 

  14. Genovese E, Angeretti MG, Ronga M, Leonardi A, Novario R, Callegari L, Fugazzola C (2007) Follow-up of collagen meniscus implants by MRI. Radiol Med 112(7):1036–1048

    Article  PubMed  CAS  Google Scholar 

  15. Ronga M, Grassi FA, Montoli C, Bulgheroni P, Genovese E, Cherubino P (2005) Treatment of deep cartilage defects of the ankle with matrix-induced autologous chondrocyte implantation (MACI). Foot Ankle Surg 11:29–33

    Article  Google Scholar 

  16. Lischuk AW, Dorantes TM, Wong W, Haims AH (2010) Imaging of sports-related hip and groin injuries. Sports Health 2(3):252–261

    Article  PubMed  Google Scholar 

  17. Jain M, Tantia O, Sasmal P, Khanna S, Bimalendu S (2010) Chronic groin pain in athletes: sportsman’s hernia with bilateral femoral hernia. Indian J Surg 72(4):343–346

    Article  PubMed  Google Scholar 

  18. Woodward S, Parker A, Mac Donald RM (2012) Non surgical treatment of a professional hockey player with the signs and symptoms of sports hernia: a case report. Int J Sports Phys Ther 7:85–100

    PubMed  Google Scholar 

  19. Overdeck KH, Palmer WE (2004) Imaging of hip and groin injuries in athletes. Semin Musculoskelet Radiol 8:41–55

    Article  PubMed  Google Scholar 

  20. Guillin R, Marchand AJ, Roux A, Niederberger E, Duvauferrier R (2012) Imaging of snapping phenomena. Br J Radiol 85:1343–1353

    Article  PubMed  CAS  Google Scholar 

  21. Macarini L, Muscarella S, Lelario M, Stoppino L, Scalzo G, Scelzi A, Armillotta M, Sforza N, Vinci R (2011) Rotator cable at MR imaging: considerations on morphological aspects and biomechanical role. Radiol Med 116(1):102–113

    Article  PubMed  CAS  Google Scholar 

  22. Macarini L, Murrone M, Marini S, Mocci A, Ettorre GC (2004) MRI in ACL reconstructive surgery with PDLLA bioabsorbable interference screws: evaluation of degradation and osteointegration processes of bioabsorbable screws. Radiol Med 107(1–2):47–57

    PubMed  Google Scholar 

  23. Krokidis M, Orgera G, Rossi M, Matteoli M, Hatzidakis A (2013) Interventional radiology in the management of benign biliary stenoses, biliary leaks and fistulas: a pictorial review. Insights Imaging 4(1):77–84

    Article  PubMed  Google Scholar 

  24. Romano A, Chiarenza A, Consoli U, Conticello C, Forte S, Uccello G, Vetro C, Cavalli M, Coppolino F, Palumbo GA, Di Raimondo F (2013) Intravenous injection of bortezomib, melphalan and dexamethasone in refractory and relapsed multiple myeloma. Annals Oncol 24(4), art. no. mds531, pp. 1038–1044

    Google Scholar 

  25. Basile A, Tsetis D, Cavalli M, Fiumara P, Di Raimondo F, Coppolino F, Coppolino C, Mundo E, Desiderio C, Granata A, Patti MT (2010) Sacroplasty for local or massive localization of multiple myeloma. Cardiovasc Intervent Radiol 33(6):1270–1277

    Article  PubMed  Google Scholar 

  26. Albers SL, Spritzer CE, Garrett WE Jr, Meyers WC (2001) MR findings in athletes with pubalgia. Skeletal Radiol 30:270–277

    Article  PubMed  CAS  Google Scholar 

  27. Anderson K, Strickland SM, Warren R (2001) Hip and groin injuries in athletes. Am J Sports Med 29:521–533

    PubMed  CAS  Google Scholar 

  28. Barile A, Erriquez D, Cacchio A, De Paulis F, Di Cesare E, Masciocchi C (2000) Groin pain in athletes: role of magnetic resonance. Radiol Med 100:216–222

    PubMed  CAS  Google Scholar 

  29. Zoga AC, Mullens FE, Meyers WC (2010) The spectrum of MR imaging in athletic pubalgia. Radiol Clin North Am 48(6):1179–1197

    Article  PubMed  Google Scholar 

  30. Major NM, Helms CA (1997) Pelvic stress injuries: the relationship between osteitis pubis (symphysis pubis stress injury) and sacroiliac abnormalities in athletes. Skeletal Radiol 26:711–717

    Article  PubMed  CAS  Google Scholar 

  31. Ekberg O, Sjoberg S, Westlin N (1996) Sports-related groin pain: evaluation with MR imaging. Eur Radiol 6:52–55

    Article  PubMed  CAS  Google Scholar 

  32. Nelson EN, Kassarjian A, Palmer WE (2005) MR imaging of sports-related groin pain. Magn Reson Imaging Clin N Am 13(4):727–742

    Article  PubMed  Google Scholar 

  33. Lischuk AW, Dorantes TM, Wong W, Haims AH (2010) Imaging of sports-related hip and groin injuries. Sports Health 2(3):252–261

    Article  PubMed  Google Scholar 

  34. Anderson MW, Kaplan PA, Dussault RG (2001) Adductor insertion avulsion syndrome (thigh splints): spectrum of MR imaging features. AJR 177:673–675

    Article  PubMed  CAS  Google Scholar 

  35. Brennan D, O’Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C, O’Neill P, Eustace S (2005) Secondary cleft sign as a marker of injury in athletes with groin pain: mR image appearance and interpretation. Radiology 235:162–167

    Article  PubMed  Google Scholar 

  36. Fricker PA (1997) Management of groin pain in athletes. Br J Sports Med 31:97–101

    Article  PubMed  CAS  Google Scholar 

  37. Robinson P, Bhat V, English B (2011) Imaging in the assessment and management of athletic pubalgia. Semin Muscoloskelet Radiol 15(1):014–026

    Article  Google Scholar 

Download references

Conflict of interest

Eugenio A. Genovese, Sofia Tack, Claudia Boi, Paolo Fonio, Elviro Cesarano, Sara Spiga, Virgilio Vinci declare that they have no conflict of interest.

Ethical Standard

The study described in this article did not include any procedures involving humans or animal.

Author information

Authors and Affiliations

  1. Radiology Department of Cagliari University, Cagliari, Italy

    E. A. Genovese, S. Tack, C. Boi, S. Spiga & V. Vinci

  2. Radiology Department of Turin University, Turin, Italy

    P. Fonio

  3. Radiology Section, Health Service, Navy Command of Brindisi, Brindisi, Italy

    E. Cesarano

  4. Department of Radiology, Azienda Ospedaliera Sant’Andrea, Rome, Italy

    M. Rossi

Authors
  1. E. A. Genovese
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Tack
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Boi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Fonio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. Cesarano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Spiga
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. V. Vinci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. A. Genovese.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Genovese, E.A., Tack, S., Boi, C. et al. Imaging assessment of groin pain. Musculoskelet Surg 97 (Suppl 2), 109–116 (2013). https://doi.org/10.1007/s12306-013-0278-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-013-0278-8

Keywords

Search

Navigation