Learning objectives
Groin pain is a commonly encountered entity in musculoskeletal radiology.
The differential diagnosis is wide and includes adductor and rectus abdominis muscle/tendon and common adductor-rectus abdominis aponeurosis pathology,
osteitis pubis,stress fractures,
herniasandreferred pain.
Diagnosis can be challenging due to a number of factors including poor localisation of pain on clinical examination,
the complexity of the groin anatomy andthe broad differential diagnosis.Radiological investigation is therefore usually required to elicit the underlying pathology.
The aims of this poster are:
1.
To review the key groin anatomy including...
Background
Groin pain can be caused by a variety of musculoskeletal pathologies occurring in and around the region of the pubic symphysis.
Assessment of groin pain can be challenging for a number of reasons:
Firstly,
the anatomy of the groin is complex due to the interconnected anatomy of the pubic symphysis and surrounding structures.
Secondly,
the differential diagnosis is wide and radiological assessment using ultrasound or MRI is usually required to reach a diagnosis.
Thirdly,
the pain is typically poorly localised making evaluation on clinical assessment...
Imaging findings OR Procedure Details
Imaging in groin pain:
Radiological investigation using ultrasound (US) or magnetic resonance imaging (MRI) is usually required to delineate the cause of groin pain.
MRI,
in particular,
plays a pivotal role in identifying the source of the groin pain and gives optimal soft tissue resolution and anatomical detail of the key groin anatomy and good visualisation of bones,
joints and soft tissue structures in the area of interest [1].
The imaging protocol for groin pain in our institution includes axial and coronal T1 weighted imaging...
Conclusion
An understanding of the complex groin anatomy and knowledge of the spectrum of pathologies that can arise in this region is crucial for the musculoskeletal radiologist.
Accurate assessment and diagnosis ensures the patient receives appropriate and effective treatment.
References
[1] Kavanagh,
E.C.,
Koulouris,
G.,
Ford,
S.
et al,
MR imaging of groin pain in the athlete.
Semin Musculoskelet Radiol.
2006;10:197–207.
[2] Omar IM,
Zoga AC,
Kavanagh EC et al,
Athletic pubalgia and "sports hernia": optimal MR imaging technique and findings Radiographics.
2008 Sep-Oct; 28(5):1415-38.
[3] Koulouris G.
Imaging review of groin pain in elite athletes: An anatomic approach to imaging findings.
Am J Roentgenol.
2008;191(4):962–972.
[4] Shetty VD,
Shetty NS,
Shetty AP.
Groin pain in athletes: a novel diagnostic approach.
SICOT-J.
2015;1:16.
doi:10.1051/sicotj/2015017.
[5]...
Personal Information
Dr Emer McLoughlin
Musculoskeletal Radiology Registrar
Royal Orthopaedic Hospital,Birmingham,UK
For questions and/or comments about this poster,
please contact me at:
[email protected]