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

A case of bilateral groin pain of sudden onset in a 14-yr-old boy is presented. The patient reported sudden onset of pain in both inguinal regions during a 100-m dash. He presented a week later to the clinic where physical examination revealed a shuffling gait, bilateral hip flexion contractures, limited active and passive hip extension, and bilateral weakness of hip flexion and knee extension. Plain radiographs of the pelvis revealed avulsion fragments minimally displaced from both anterior inferior iliac spines (AIIS). Pain relief in the acute phase was achieved by limiting ambulation until weight bearing was painless. The patient was treated conservatively and returned to full speed running in 10 wk. Only one case of bilateral AIIS avulsion fractures has previously been reported. AIIS avulsion fractures that are not widely displaced may be treated conservatively. Following a careful program of rehabilitation, full functional recovery following AIIS avulsion fractures may be achieved in 4-6 wk.
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PMID:Bilateral anterior inferior iliac spine avulsion fractures. 877 48

Our purpose was to assess the role of MRI in evaluating the musculoskeletal system in athletes with chronic pain laterally in the groin of unknown etiology. Magnetic resonance imaging (MRI) of the pubic ring was performed in 11 young athletes (soccer players) with long-standing groin pain. MR findings were compared with plain films and isotope examination (bone scan Tc 99M). Abnormal MRI findings included a broadened and irregular symphysis with a characteristic pattern of low signal intensity on T1W and high signal intensity on T2W images localized in the superior pubic ramus at a distance from the symphysis. Positive findings were also observed on plain films and on nuclear medicine studies. However, the imaging findings in the superior public ramus of the symphysis was located considerably more laterally on MRI. MRI is a valuable method for evaluating discrete and ambiguous pelvic pain in athletes, particularly for identifying concomitant changes in the superior ramus, which may give rise to long-standing pain localized laterally in the groin.
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PMID:Sports-related groin pain: evaluation with MR imaging. 879 50

Protagonists of laparoscopic hernia repair with mesh emphasize the tension-free repair as a main advantage. Thus, conventional techniques of hernia repair with tissue approximation and suture lines are questioned. Postulated advantages of the tension-free repair are less postoperative pain, shorter labour disability, less recurrences and less complications. The results of our own patients (primary hernia n = 2025, recurrent hernias n = 897) operated with the Shouldice technique were evaluated with regard to the postulated advantages of the tension-free repair. 95% of our patients were operated under local anesthesia. The amount of analgetic drugs/patient decreased from 45% first postoperative day to 20% second postoperative day. The individual judgement of pain with a visual analogue scale decreased to zero at the second postoperative day. Chronic groin pain persisted in 1.4% after primary hernia repair and 2.6% after repair of recurrent hernias in our patients. Mobilizing the patient from the operating table the postoperative hospital stay is 3,7 days after primary hernia and 6,7 days after recurrent hernia. The length of labour disability correlated significantly with the occupation. 90% of self-employees are back at work 3 weeks postoperatively while, in the group of employers, it lasts 8 weeks. 5-year follow-up reveals a recurrence rate of 1.3% after primary hernia and 3.1% after recurrent hernia. With the Shouldice repair the modern goals of hernia surgery are feasible. Therefore, a primary tension-free repair is not a "conditio sine qua non".
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PMID:[Pro-Shouldice: primary tension-free hernia repair--conditio sine qua non?]. 896 34

Chronic groin pain in athletes is often difficult to diagnose and treat. There are many anatomic structures in the inguinal and groin region that have the potential to cause pain. We report 32 cases of a previously undescribed condition in athletes of "obturator neuropathy," a fascial entrapment of the obturator nerve where it enters the thigh. This condition represents a type of groin pain in athletes that is treatable by surgical means. There is a characteristic clinical pattern of exercise-induced medial thigh pain commencing in the region of the adductor muscle origin and radiating distally along the medial thigh. Needle electromyography demonstrates denervation of the adductor muscles. Surgical neurolysis treatment provides the definitive cure of this problem, with athletes returning to competition within several weeks of treatment. The surgical findings are entrapment of the obturator nerve by a thick fascia overlying the short adductor muscle. The role of conservative treatment in the management of this condition is unknown at present.
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PMID:Obturator nerve entrapment. A cause of groin pain in athletes. 916 24

We report the case of a 74-year-old woman who presented with acute-onset right groin pain irradiating to the thigh anteriorly after having suffered for a few weeks from slight knee pain. As a CT scan showed multiple herniated intervertebral discs and spinal stenosis at the L3-L4 level, she was referred to a neurosurgical unit with the tentative diagnosis of L2-L3 radicular pain. Investigations (MR, myelography with CT scan) showed severe acquired lumbar canal stenosis. Decompression surgery was finally postponed because of the patient's serious cardiac medical history and she was referred to us for conservative treatment. She was found to have iliopsoas bursitis with chondrocalcinosis of the knee. Local steroid injections of the two sites abolished her symptoms. We draw attention to the possible pitfalls that the radiographic appearance and one of the multiple clinical presentations of this unrare pathology may represent. Whenever a patient comes walking with crutches, avoids putting weight on his or her leg, and radicular pain is suspected, we advise consideration of other extra-spinal causes for the pain.
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PMID:Iliopsoas bursitis and pseudogout of the knee mimicking L2-L3 radiculopathy: case report and review of the literature. 939 6

This study was undertaken to determine the most common referral patterns of hip pain in patients scheduled to undergo primary and revision total hip replacement. The exact location of pain from the hip was recorded prospectively for 323 patients (358 hips) who had primary total hip replacement and for 94 patients who had revision of a loose total hip. Seventy-three percent of patients with primary hip disease had pain in the groin, and 27% had groin pain that referred to the knee. Eighty-nine percent of 57 patients who had femoral component loosening had thigh or knee pain, and all of the 34 patients who had a loose acetabular component with a well-fixed femoral implant had pain in the hip region without distal radiation of pain. These results indicate that in patients who have a painful total hip, thigh pain is highly suggestive of femoral component loosening and pain located around the hip region that does not radiate distally is associated with isolated acetabular component loosening.
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PMID:Referral patterns of hip pain in patients undergoing total hip replacement. 950 64

This article reports the results of 41 hips in 36 patients who underwent bipolar hemiarthroplasty for primary osteoarthritis of the hip. Surgical technique included a complete capsulectomy and light reaming of the acetabulum in all patients. The average follow-up was 8.9 years with a minimum of 8 years. Harris hip scores improved from 49 preoperatively to 93 at the latest follow-up, with 95% of the hips rated as excellent or good. Two patients had mild, intermittent groin pain, while a third developed recalcitrant pain necessitating revision. Migration of the bipolar cup was minimal with an average of 2.3 mm superior and 2.1 mm medial migration. Survivorship analysis demonstrated an 89.5% survival rate at 10 years.
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PMID:Bipolar hemiarthroplasty for primary osteoarthritis of the hip: a review of 41 cases with 8 to 10 years of follow-up. 957 76

In this study 45 patients with groin or buttock pain after hemiarthroplasty were evaluated 2 to 7 years after conversion to total hip arthroplasty. Groin or buttock pain was completely relieved in 36 patients (80%) and partially relieved in an additional 4 patients (9%). After conversion surgery, 9 patients continued to have groin or buttock pain, but no factor could be identified that would predict an unsuccessful result. The hypothesis tested in this study was whether conversion of a hemiarthroplasty to a total hip arthroplasty eliminates groin pain. Because a significant number of patients (up to 20%) will continue to have some groin or buttock pain after conversion surgery, patients should be warned of this contingency before surgery.
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PMID:Conversion of hemiarthroplasty to total hip arthroplasty: can groin pain be eliminated? 974 37

Groin pain in the soccer athlete is a common problem accounting for 5% of soccer injuries. Groin distribution has proved to be the most common cause of groin pain. Other causes are direct trauma, ostetis pubis, muscle injuries, fractures, bursitis, hip problems, and hernia and referred pain. Soccer players with groin pain present a complex management problem that is discussed.
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PMID:Groin pain in the soccer athlete: fact, fiction, and treatment. 992 2

Pubic pain is a common symptom in soccer players. Its cause can be difficult to determine. We report a case in a 19-year-old soccer player who had an abscess in the obturator internus muscle. We are aware of only one similar report in the literature. Painful limitation of internal rotation of the hip and evidence of infection suggested the diagnosis, which was confirmed by magnetic resonance imaging. In a soccer player, a fever and groin pain do not always indicate osteitis pubis. Limitation of internal rotation of the hip should suggest a lesion in the obturator internus muscle.
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PMID:Pubic pain in athletes: a case due to an abscess in the obturator muscle. 1003 2


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