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

Acute complications include fractures and prosthesis dislocations. Most chronic complications involve mechanical or septic loosening and aggressive granulomatosis. Greater trochanteric pseudarthrosis, periprosthetic soft tissue ossifications or prosthesis conflict with the psoas muscle can also be responsible for groin pain. Most complications are detected with serial plain radiographs, but additional imaging techniques including CT scan and scintigraphy are sometimes necessary for pretreatment diagnosis. Pain generally indicates a complication but aggressive granulomatosis can be asymptomatic, thus warranting systematic annual plain radiographic control.
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PMID:[Imaging of complications following hip arthroplasty]. 1196 58

A 51-year-old nurse underwent an uneventful TVT procedure. Two weeks postoperatively she developed intractable suprapubic pain directly over the iliopectineal ligaments consistent with a "post-colposuspension syndrome". This failed to respond to conservative therapy and she subsequently underwent exploration of the retropubic space. The TVT sling was found to be densely adherent to the iliopectineal ligaments, from which it was dissected free and then divided, leaving the part where it passes through the endopelvic fascia intact. The pain resolved immediately and the woman remained continent. This diagnosis should be considered in a woman presenting with groin pain following a sling procedure.
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PMID:Post-colposuspension syndrome following a tension-free vaginal tape procedure. 1214 Jul 14

Stress fracture of the femoral neck is rare and often initially missed. A high index of clinical suspicion is required in athletes presenting with a history of insidious onset, exertional groin pain and pain at the extremes of hip motion on examination. Regular review is recommended to prevent progression of the stress fracture to a displaced fracture, as this significantly worsens long term outcome.
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PMID:Femoral neck stress fracture: the importance of clinical suspicion and early review. 1214 25

Groin pain may be produced by a true hernia, trauma to the groin structures or peripheral nerve, or root compression at various levels. Approximately 4,000 patients underwent inguinal herniorrhaphy (group A). An additional 134 patients complaining of groin pain and exhibiting no evidence of primary or recurrent hernia fell into two categories: 30 patients who had a previous herniorrhaphy (group B) and 104 patients without previous surgery (group C). Group B patients underwent a diagnostic nerve block which, when positive, suggested ilioinguinal nerve compromise at the wound. Those who failed conservative measures underwent nerve division. Group C patients were advised to decrease recreational and occupational activities; if that failed, they underwent lumbosacral spine imaging. There were no neuralgias in group A. Eight group B patients responded to conservative measures; the 22 others required ilioinguinal nerve division which relieved their pain. In group C, 42 patients responded to physical activity restriction plus NSAIDs; the remaining 62 underwent imaging which revealed lumbosacral bone pathology producing root compression and were referred to orthopedists. Lumbosacral spine pathology should be suspected in patients who complain of groin pain in the absence of hernia or previous herniorrhaphy. Recognition of this syndrome may avoid negative exploratory herniorrhaphies.
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PMID:Groin pain in the absence of hernia: a new syndrome. 1215 41

Women with a common bladder infection and those with interstitial cystitis (IC) both suffer from severe groin pain, a strong desire to urinate with just small amounts of urine emerging, and waking up during the night to urinate. The sole symptomatic difference between common bladder infections and IC is that women with a common bladder infection note burning or stinging during urination while those with IC find relief from pain only during urination. Bacteria cause common bladder infections so antibiotics can treat these infections. The causes of IC are unknown, thus making it difficult to treat. IC consists of small, pin point holes in the lining of the bladder. A healthy bladder prevents bacteria from adhering to the bladder and causing infections. It also prevents acid and other toxins in the urine from irritating the bladder. Bacteria in the bladder are not uncommon. They take the following path to enter the bladder: the colon, bowel movement, vagina where body's defenses usually kill the bacteria, urethral opening, urethral opening, and bladder. In women with an intact bladder lining, the bacteria stay in the urine until they are released with the urine. In bladders with small, pin point holes, the bacteria cause an infection. The in and out motion of sexual intercourse or massaging of the genital area tend to push bacteria up into the urethra. Women using the diaphragm experience twice as many bladder infections as those who do not use the diaphragm. Possible reasons include a change in the chemical balance of the vagina, maybe inducing more bacteria growth, and the diaphragm's hard rim pushed against the neck of the bladder, resulting in bruising and swelling and making women more vulnerable to infection. Women who use the diaphragm and suffer from recurrent bladder infections should consult a provider to change to another birth control method.
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PMID:Understanding interstitial cystitis and other bladder disorders. 1228 8

Inguinal and testicular pain are challenging problems for which no reliable, standardized treatment exists. We report 3 patients with groin pain or orchialgia who were treated with pulsed radiofrequency of the nerves innervating these areas. All 3 patients reported complete pain relief at their 6-month follow-up visits. The techniques and settings used for the nerve blocks and radiofrequency procedures are explained in detail, along with a brief synopsis of the rationale for using it. Randomized, placebo-controlled studies are needed to better assess the efficacy of this procedure and identify eligible candidates.
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PMID:Pulsed radiofrequency as a treatment for groin pain and orchialgia. 1263 76

Impingement of the iliopsoas muscle due to a protruding acetabular component is an uncommon cause of pain after total hip arthroplasty. We report the case of a 59 year old female patient who developed groin pain one year after revision arthroplasty and reconstruction of the acteabular defect with an acetabular reinforcement ring due to a loosened cup. THERAPY AND FOLLOW UP: After revision of the right hip via an anterior approach we used bone cement to smooth the anterior edge of the acetabular reconstruction ring and created a smooth rim for the iliopsoas tendon. At follow up 2 years later the patient was satisfied with the result, she complained about very rare recurrent groin pain, without any need for further treatment.
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PMID:[Impingement of the iliopsoas muscle after revision of a loosened acetabular cup with an acetabular reinforcement ring]. 1269 27

Pain after total hip arthroplasty (THA) may be due to a number of factors, including dysfunction of the iliopsoas tendon. We report a case of persistent groin pain after THA. The pain was successfully treated using iliopsoas tenotomy rather than revision of any prosthetic component.
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PMID:Iliopsoas tendon dysfunction as a cause of pain after total hip arthroplasty relieved by surgical release. 1272 36

The occurrence of pelvic insufficiency fractures in patients with rheumatoid arthritis has not previously been well emphasized. These fractures are difficult to detect clinically, and appropriate radiological investigation is necessary for diagnosis. A 72-year-old woman with rheumatoid arthritis presented with severe left groin pain. Pelvic radiographs showed parasymphyseal fractures, and marked instability of these fractures was observed at the follow-up 2 weeks later. Computed tomographic scan of the sacrum showed a widened linear fracture gap in the left sacral ala. Because the patient's pain was so severe that she could not change position, external fixation was performed to achieve rapid pain relief and early mobilization. Although most patients with these fractures respond well to simple conservative treatments, parasymphyseal fractures combined with sacral fractures may cause disruption of the pelvic ring and occasionally need operative management.
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PMID:Unstable pelvic insufficiency fracture in a patient with rheumatoid arthritis. 1274 11

Dorsal root ganglion neurones with dichotomising axons are present in several species and are considered to play a role in referred pain. Clinically, patients with lesions in the lower lumbar discs occasionally complain of pain in the groin. We investigated the existence of dichotomising afferent neurones projecting axons both to the lumbar disc and to the groin skin, using the double fluorescent-labelling technique in rats. We observed neurones labelled with a tracer applied at the ventral portion of the LS-L6 disc and another tracer placed on the groin skin in L1 and L2 dorsal root ganglia. Our results showed that the double-labelled neurones had peripheral axons which dichotomised into both the LS-L6 disc and the groin skin, indicating the convergence of afferent sensory information from the disc and groin skin. Our findings provide a possible neuroanatomical mechanism for referred groin pain in patients with disc lesions.
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PMID:Dorsal root ganglion neurones with dichotomising afferent fibres to both the lumbar disc and the groin skin. A possible neuronal mechanism underlying referred groin pain in lower lumbar disc diseases. 1279 71


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