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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stress fractures and reactions of the pubic ramus, pubic symphsitis, gracilis syndrome, pelvic avulsion injuries, femoral stress fractures, degenerative osteoarthritis, discogenic pain, and spondylolysis are among the multiple conditions causing groin pain in the athlete. These conditions occasionally have uncertain etiologies and are contributed to by poor training techniques and ill-repaired running shoes, combined with minor congenital anomalies that may have been silent prior to the demands of athletic competition. Roentgen documentation of the specific injury enables early appropriate treatment and minimal "down time".
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PMID:Roentgen examination of groin and hip pain in the athlete. 333 29

The value of herniography was reviewed in 45 patients with a variety of urological symptoms (4 with flank pain, 20 with pain from the funicle or scrotum, 11 with symptoms simulating prostatitis and 10 with ill-defined symptoms from the small pelvis). In no patient was a groin hernia palpable at physical examination. However, herniography revealed an inguinal hernia in 6 patients who underwent herniorrhaphy, whereafter 5 became asymptomatic. We recommend herniography in patients with long-standing obscure groin pain to reveal the presence of a nonpalpable inguinal hernia.
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PMID:Inguinal hernia in urological patients: the value of herniography. 337 96

In the years 1974 to 1981, herniography was performed in 78 athletes with groin pain. The investigation comprised 101 painful groin sides in 23 athletes with bilateral symptoms. Before herniography, a hernia was palpated in only eight (7.9 percent) groins with pain. Hernias were found at herniography in 84.2 percent of the symptomatic groin sides and in 49.1 percent of the asymptomatic groin sides. Sixty-three hernia operations were performed. The herniographic and operative diagnoses corresponded well. Direct hernias dominated among the operated athletes, and were found in 55.6 percent of those below 30 years of age. Altogether 69.8 percent of the operated patients were cured by hernia repair and another 20.6 percent were improved. Tenoperiostitis of the adductor muscles was the most frequent diagnosis in those not cured by operation and among the nonoperated patients. Herniography was of great value in selecting those patients who needed a repair. A broad differential diagnostic approach when examining these patients is of the utmost importance.
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PMID:Herniography in athletes with groin pain. 397 96

We describe five cases of radiographically proven stress fracture of the pubic ramus in serious runners, three of whom were elite female marathoners. In a further two cases in which radiography failed to support the clinical diagnosis, there was bone scintigraphic evidence of stress fracture. Another five cases had the identical clinical presentation, but the diagnosis was not confirmed radiologically and bone scanning was not performed. Most patients experienced persistent groin discomfort during any activity for the first 4 weeks after injury, but all recovered completely after 8 to 12 weeks of rest, in particular, avoidance of running. In common with other studies, we found that the injury occurred in competitive runners, especially females, and was likely to develop during competitive races or intensive training sessions. We suggest that a diagnosis of pelvic stress fracture or stress fracture syndrome can be made with confidence, even in the absence of radiographic evidence, if the following three features are present in a long distance runner presenting with groin pain: First, activity causes such severe discomfort in the groin that running is impossible. Second, the athlete develops discomfort in the groin when standing unsupported on the leg corresponding to the injured side (positive standing test). In some cases the pain is so severe that standing on one leg is impossible. Third, deep palpation reveals extreme, exquisite nauseating tenderness localized to the pubic ramus and not to the overlying soft tissues. The diagnosis can be confirmed by bone scintigraphy where such facilities exist.
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PMID:Pelvic stress fractures in long distance runners. 398 59

Obscure groin pain was investigated in 250 consecutive patients (including 171 males) with no palpable hernia or previous hernia operation. Herniography revealed nonpalpable but symptomatic hernia in 51% of the male and 21% of the female patients. Among the hernia patients with bilateral pain, 40% had unilateral hernia. Direct-type hernia was most commonly found. Of the surgically treated patients, 87% were free from groin pain postoperatively. Further clinical investigations with a broad diagnostic approach gave a treatable diagnosis in 70% of the patients without hernia surgery. Spontaneous improvement occurred during the investigation in 25%, and the cause of groin pain remained unclear in 5% of the patients. Herniography is a valuable diagnostic tool in obscure groin pain and its use is justified at an early stage of investigation. "Blind" exploration can thus be avoided.
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PMID:Herniography in the diagnosis of obscure groin pain. 409 71

Positive contrast herniography has been used in adult patients with unexplained groin pain for the detection of clinically occult inguinal hernias. Herniography involves puncture of the anterior abdominal wall and injection of an iodine contrast medium. Complications may be encountered from either phase of the procedure and were recorded in 19 (5.8%) of 330 herniographies. Difficulties in puncturing the abdominal wall as well as in injecting the contrast medium were noted in 12 (3.6%); these difficulties included injection into the stomach (one patient), left iliac vein (one patient), colon (three patients), and anterior abdominal wall (four patients). In three patients a painful hematoma developed at the site of puncture. Adverse reaction to the injection of contrast medium (80 ml meglumine metrizoate, 200 mg l/ml) was noted in seven (2.1%) patients. Five of these had a vasovagal reaction and two developed severe abdominal pain within a few hours after the examination. They were hospitalized for 24 hr due to suspected peritonitis. When 52 consecutive patients were asked about pain during or after the injection of contrast medium, 15% described severe pain while 23% admitted moderate pain. As in other invasive examinations, herniography involves a certain risk. This study shows that complications occur with the same or lower frequency than in urography.
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PMID:Complications after herniography in adults. 660 May 40

The sacroiliac joint itself and the specific diagnosis of sacroiliac dysfunction are both underappreciated causes of pain in the low back, the pelvis, and the proximal lower extremities. An anatomically atypical synovial joint, its extensive innervation accounts for multiple modes of pain presentation. The joint and its associated ligament complex are subjected to rather constant and significant stresses. These combined factors contribute to the body of patients who present with low-back, buttock, proximal-thigh, and groin pain. Physical examination usually is an attempt to assess for presumed abnormal motion of the sacroiliac or to provoke discomfort by stressing that joint. Nonoperative treatment is usually physical therapy, and both diagnostic and therapeutic injection of the sacroiliac joint may be employed. Surgery is a treatment of last resort. There is a lack of long-term studies that address the natural history of this problem and its treatment.
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PMID:The sacroiliac joint: an underappreciated pain generator. 1798 19

This report describes a case of fibromyalgia developing following a workplace injury, but in which the issues of compensation and work disability were not relevant. A previously healthy 37-year-old woman developed back and groin pain after lifting a heavy box. Over the next months, pain and allodynia gradually spread over her body, and headaches, sleep disturbance, paresthesias, and bowel symptoms developed for the first time. The pain was constant and severe, invading and interfering with every area of daily function. Surprisingly, no previous case reports or definition of post-traumatic fibromyalgia could be found. This case report, narrated by the patient, suggests that there is such an entity as post-traumatic fibromyalgia, and that central nervous system plasticity plays a central role.
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PMID:Post-traumatic fibromyalgia: a case report narrated by the patient. 897 Feb 75

Groin pain in athletes may be due to muscle strains, referral of pain from internal organs, and/or hernia. This study includes ten elite level hockey players unable to continue their careers due to groin pain. These patients did not present with the typical causes described above, including hernia. They were explored surgically and were found to have tears in the floor of the inguinal ring which were repaired either directly or with a synthetic mesh reinforcement (seven cases). All the patients have subsequently returned to hockey. Because these patients presented with symptoms similar to hernia, but did not have a hernia at the time of surgical exploration, they were considered to have a condition previously described as "sportsman's hernia".
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PMID:Abdominal wall muscle tears in hockey players. 775 Oct 76

Groin pain is a common problem in athletes. Osteitis pubis, a chronic inflammatory condition involving the pubic symphysis, is a rare cause, and pyogenic osteomyelitis of the pubis is seen even more rarely in healthy athletes. We report one of four cases of pyogenic osteomyelitis of the pubis seen at our institution, review our experience with all four cases, and present a review of the literature (7 cases). The diagnosis is established by the presence of extreme pain, point tenderness at the pubic symphysis, fever, and either a positive culture of blood, needle aspiration, or open biopsy of the pubis. White blood cell count, erythrocyte sedimentation rate, and the results of bone scan and computerized tomography may initially be normal and therefore cannot exclude the diagnosis. Prompt treatment with intravenous (i.v.) antibiotics effective against Staphylococcus aureus (causative organism in all documented cases-9/11) should initially be administered and then guided by culture and sensitivity information. Oral antibiotics should be given if the infection is responsive to i.v. antibiotic treatment. Prompt recognition and treatment with antibiotics may obviate the need for surgical debridement. All athletes who returned to sports activity did so by 6 months after diagnosis.
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PMID:Osteomyelitis of the pubic symphysis in athletes: a case report and literature review. 779 75


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