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

In a prospective 3-year study herniography was used to assess patients with unexplained groin pain in whom clinical signs were inconclusive. Fifty-two patients were studied. No serious complications were observed. Twenty-two hernias were identified in 18 patients. The positive herniographic findings were confirmed at operation in 12 patients. Of 34 patients with a negative herniogram, none has developed a hernia. Pain settled spontaneously in 29 patients and five were referred to a pain clinic for further management.
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PMID:Herniography for occult hernia and groin pain. 782 Apr 95

Forty-nine patients with chronic obscure groin pain, bilateral in four, presented to one general surgeon in a 12-month period. Inflammation ('enthesopathy') at the pubic insertion of the inguinal ligament was the cause in 30 patients (32 groins). This has not previously been recognized as a cause of chronic groin pain, possibly because the exact site of tenderness can be obscured by the pubic pad of fat. Enthesopathy also occurred in five rectus and one adductor longus tendons (one patient had inflammation in both). Infiltration with long-acting steroid (1 per cent triamcinolone) and local anaesthetic (2 per cent lignocaine) was offered to all patients with localized tenderness of tendon or ligament. A questionnaire survey 3-15 months after injection showed a better outcome after treatment than when injection was declined. Other causes of pain included nerve entrapment (five cases), spinal referred pain (five in four patients) and ureteric stones (two). Inguinal hernia is sometimes coincidental rather than causative of the pain. In three patients the pain had subsided and no diagnosis was made. Simple diagnostic and therapeutic measures may relieve chronic groin pain and spare patients elaborate investigation or unnecessary operation.
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PMID:Chronic obscure groin pain is commonly caused by enthesopathy: 'tennis elbow' of the groin. 782 91

Fractures of the hip following seizure are uncommon but may have devastating consequences if allowed to go unrecognized. The presence of groin pain suggests hip pathology, but the ability to ambulate does not necessarily rule out fracture. Sprains around joints are common; hip sprains are not. Given the powerful contractions that occur with convulsions, musculoskeletal pain following seizure should not be dismissed until fractures or dislocations have been ruled out. We report the case of a young man with bilateral hip fractures following seizure, illustrating the violent muscular forces possible.
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PMID:Bilateral femoral neck fractures following a grand mal seizure. 797 8

A 58-year-old woman with rheumatoid arthritis (RA) presented with persistent hip pain and an inguinal mass. Considerable liquid had collected inside the iliopsoas bursa, apparently not in communication with the hip joint, as shown by ultrasonography and computed tomography (CT). After one month of systemic steroidal therapy (25 mg/day prednisone), the palpable inguinal mass and pain had disappeared. Iliopsoas bursitis should be suspected in RA patients with a long history of disease presenting with an inguinal mass, persistent groin pain or unilateral leg swelling. The lack of communication between the hip joint cavity and bursa may be considered as a favourable prognostic index. Steroid treatment should be always attempted in order to avoid surgery.
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PMID:Iliopsoas bursitis in rheumatoid arthritis. 827 92

Seventy-one athletes with 74 stress injuries to the femur were studied using a case-controlled design. Forty-three were females (26.6 yrs) and 28 were males (31.2 yrs). Each patient had exercise-induced pain in the hip, groin or thigh and a Tec-99m-MDP bone scan showing focal uptake of radionuclide in the femur. Running was the most common activity at the time of injury (89.2%) followed by triathlon (4.6%) and aerobic dance (4.6%). Thirty per cent of the runners had increased their training duration immediately prior to their first symptom. Anterior thigh pain was the most frequent site of exercise-induced pain (45.9%) followed by hip pain (27%) and groin pain (8.1%). During the clinical examination, when asked to hop on the affected limb, 70.3% of the patients had pain reproduced in the hip, groin or anterior thigh. There were 39 cases (53%) involving focal uptake of radionuclide in the femoral shaft, 15 (20%) in the lesser trochanter, 11 (15%) in the intertrochanteric region between the femoral neck and the greater trochanter, 8 (11%) in the femoral neck and 1 (1%) in the greater trochanter. Two patients suffered displaced fractures, one at the femoral neck and the other in the shaft of the femur. Neither patient had previously sought medical attention for their leg pain. Of 46 plain radiographs taken, only 11 (24%) were abnormal. The mean time to diagnosis and recovery were 6.6 and 10.4 weeks respectively. Substitution of cycling and water exercise for running were the most common therapeutic interventions.
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PMID:Exercise-induced stress injuries to the femur. 840 67

Twenty-two hips with protrusio acetabular deformity in 14 patients received bipolar socket hemiarthroplasty combined with bone-grafting to the medial wall defect. The surgical technique included crushed cancellous grafting and attention to adequate rim contact for the socket. Results were evaluated at a mean of 54 months after surgery (range, 36-76 months). On hip had thigh pain attributable to a loose femoral component. No patient had groin pain at follow-up examination. A satisfactory range of motion was achieved in all but one case, and an average increase of 40 points in the Harris hip score was realized. Radiographically, all acetabuli were returned to a more normal, inferolateral position. Socket migration (measured relative to the teardrop) in the range of 3-7 mm was noted in 5 hips; the remaining 17 hips displayed no or minimal migration of the socket (< 3 mm). The bipolar socket with crushed cancellous graft appears to be an acceptable surgical alternative in protrusio acetabuli, providing a reliable relief of pain, satisfactory functional results, and a restoration of acetabular bone stock in the majority of cases.
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PMID:Bipolar socket in protrusio acetabuli. 3-6-year study. 840 93

Pain after total hip arthroplasty (THA) can be caused by a multitude of conditions, including infection, aseptic loosening, heterotopic ossification, and referred pain. It is also recognized that soft tissue inflammation about the hip, such as trochanteric bursitis, can lead to hip pain after THA. Two cases of persistent iliopsoas tendinitis following THA are reported, which are believed to be caused by psoas tendon impingement against a malpositioned, uncemented, metal-backed acetabular component. The authors are unaware of previous reports of this problem, and suggest that the problem be considered in the differential diagnosis of groin pain following THA.
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PMID:Anterior iliopsoas impingement after total hip arthroplasty. 2684 28

Insufficiency fractures of the pelvis are commonly overlooked as causes of severe hip and low back pain. Predisposing factors include postmenopausal osteoporosis, corticosteroids, and local irradiation. Differential diagnosis includes metastatic disease to bone. We present the case of a 65-year-old woman who had a two-month history of low back pain and left groin pain. Her medical history included osteoporosis and endometrial cancer that was treated with radiation therapy to the pelvis 1 year prior to presentation. Despite bed rest, analgesics, and therapeutic modalities, her pain remained intractable and prevented ambulation. Plain radiographs showed no fracture. Computed tomography (CT) and magnetic resonance imaging showed fractures of the pelvis but were suggestive of malignancy. CT-guided bone biopsy was consistent with radiation osteonecrosis. After diagnosis and continued therapy, the patient progressed to ambulation with moderate discomfort. Failure to diagnose insufficiency fractures could lead to further pelvic irradiation, compromising already weakened bones and causing prolonged disability.
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PMID:Pelvic insufficiency fractures after irradiation: diagnosis, management, and rehabilitation. 860 69

A 16-year-old male Taekwondo player was admitted with a 1-day history of right groin pain and a palpable mass in the right lower abdominal quadrant following a Taekwondo training session. No history of direct trauma was given, but the pain followed a high inward-to-outward kick. The patient was not on any medication, and tumour and infection were excluded. A high-resolution real-time ultrasound scan identified a well-defined, hyperechoic, heterogeneous mass in the substance of the right iliopsoas muscle, compatible with a collection of partially clotted blood, confirming the clinical diagnosis of iliopsoas haematoma. After conservative treatment the patient resumed training and is now fully asymptomatic.
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PMID:Iliopsoas haematoma in an adolescent Taekwondo player. 873 19

This study was designed to investigate neural mechanisms of referred pain in lumbar intervertebral disc lesions. Patients with a degenerative disc in lower lumbar segments occasionally complain of groin pain, which cannot be explained anatomically as having a radicular origin. In rats pretreated with intravenous application of Evans blue dye, the dye extravasation appeared in the groin skin after application of capsaicin to the ventral portion of the L5-6 intervertebral disc. This response occurred even in rats with a sectioned L-5 spinal nerve and sympathetic trunks, but did not occur in rats with a sectioned genitofemoral nerve. Capsaicin topically applied to the sciatic nerve did not cause dye extravasation in the hindpaw. Therefore, groin dye extravasation was not due to a direct effect of capsaicin but, rather, presumably was caused by an "antidromic axon reflex" of dichotomizing C fibers or to a segmental sympathetic reflex causing vascular permeability. The present results indicate that the ventral portion of the lumbar discs is neurally connected to the groin skin via the upper (L-2) lumbar spinal nerves in rats. Groin pain coincident with low-back pain may be explained as referred pain, indicating that a lesion is present in the ventral portion of the lumbar intervertebral disc space.
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PMID:Neural connection between the ventral portion of the lumbar intervertebral disc and the groin skin. 875 63


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