Learning objectives
Groin pain is a yet challenging diagnostic and management dilemma for the sports clinician.
It accounts for approximately 5–18% of all athletic injuries.
Nevertheless,
pubalgia is not only seen among athletes but can also occur among a wide category of patients.
Disorders of pubic symphysis have been poorly understood due to the complexity of the anatomy of this region.
After a brief anatomical and biomechanical review,
this article discuss imaging findings of the principal pathological aspects including traumatic injury to the adductor and rectus abdominis...
Background
.
A.
Anatomy:
Although the groin specifically lacks formal and distinct anatomic boundaries,
for practical purposes it may be considered to be the area of the body that encompasses:
- Both inguinal regions
- The pubic symphysis
- The proximal aspect of the adductor compartment of both thighs.
We review fundamental anatomical features that are imperative to accurately interpret imaging findings when assessing groin pains.
The anatomy of the groin consists of a complex array of musculoaponeurotic supporting structures.
Rectus abdominis muscles :
Both lateral...
Findings and procedure details
I.Procedure details: imaging approach and technique:
Assessment of patients referred to us with groin pain relied on a multitechnique approach.
1.Radiographs:
Frontal pelvic radiographs is used in the first line.
Although often normal,
radiographic assessment allows evaluation of symphyseal alignment and screening of the hips,
sacroiliac joints,
and lower lumbar spine for any disorders,
which if detected,
may initiate more advanced imaging of the relevant region.
Focal osseous lesions of the pelvis as well as arthropathy may be detected.
The early signs of origin of...
Conclusion
The radiologist plays a pivotal role in the assessment of patients with groin pain and it is entirely appropriate that a multitechnique approach is commonly used.
A knowledge of the anatomic framework of the structures present and familiarity with the imaging manifestations allow either an accurate diagnosis to be made or a relevant list of differential diagnoses to be formulated
Diagnostic imaging will allow in most cases timely and appropriate treatment in this clinical setting.
The treatment is generally conservative,
initially with a period of...
References
[1] Pesquer L,
Moreau-Durieux MH,
Meyer P.
IRM des pubalgies.
J
Traumatol Sport 2013;(3):42—6.
[2] Branci S,
Thorborg K,
Nielsen MB,
Holmich P.
Radiological
findings in symphyseal and adductor-related groin pain in athletes: a critical review of the literature.
Br J Sports Med
2013;47(10):611—9.
[3] Palisch A,
Zoga AC,
Meyers WC.
Imaging of athletic pubalgia and
core muscle injuries: clinical and therapeutic correlations.
Clin
Sports Med 2013;32(3):427—47.
[4] Robertson BA,
Barker PJ,
Fahrer M,
Schache AG.
The anatomy
of the pubic region revisited: implications for...