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

A 66-year-old man was admitted to a hospital rehabilitation unit for the management of chronic groin pain. Since the groin pain began, he had been unable to bear weight on his right foot. During a podiatric examination, the patient reported sharp pain at the apex of his right hallux. A full podiatric assessment was undertaken to evaluate his vascular, neurologic, and biomechanical status. The patient's ankle-brachial index was found to be 0.34 in the right lower limb and 0.68 in the left lower limb. After vascular assessment, the patient was diagnosed as having chronic ischemia of the right leg. He underwent left-to-right femoral-to-femoral bypass graft surgery to salvage the right lower leg and foot.
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PMID:Chronic ischemia presenting as muscular groin pain. 1790 46

Sportsman's hernia is an increasingly recognized cause of chronic groin pain in athletes. Although the definition is controversial, it is a condition of chronic inguinal/pubic exertional pain caused by rectus abdominal wall weakness or injury without a palpable hernia, usually affecting high-performance male athletes. Diagnosis is made after careful history and physical examination. Some radiographic studies such as ultrasound or MRI may be helpful in evaluating these patients and ruling out other pathology, although no radiographic study can rule out sportsman's hernias. Because sports hernias are not true hernias but an injury in the rectus insertion, unilateral or bilateral rectus reattachment is the most appropriate surgical treatment. This reattachment may be done in combination with adductor release in the setting of adductor pain or weakness on physical examination. Other surgical repairs (eg, Lichtenstein, Shouldice, Kugel, laparoscopic) do not stabilize the pelvis and tend not to be as successful. In the motivated patient, after surgical repair and physical rehabilitation, 95% are free of pain and able to return to competitive sports.
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PMID:Sports hernias. 1797 64

A 14-year-old was admitted with right groin pain which has started after kicking ball in a football game one week before. He had limited active and passive hip extension. A plain AP radiograph of the pelvis revealed a bone fragment displaced inferiorly about 1 cm from the right anterior inferior iliac spine. The patient was treated conservatively with analgesics and limited weight bearing. Four weeks later, range of motion was normal without pain and at eighth week the hip flexors regained full strength.
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PMID:Avulsion fracture of the anterior inferior iliac spine. 1797 17

The evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, multiple pathologies often coexist, different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have had symptoms significantly limit their activity, have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. Often times the diagnosis given depends on the physician's specialty. This article focuses on the groin structures and looks at three specific entities-"sports hernia," pubic bone edema, and entrapment neuropathies-as potential causes of chronic groin pain. Potential diagnostic and treatment strategies are also discussed.
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PMID:Evaluation of groin pain in athletes. 1800 6

Groin pain is frequent but often problematic as it covers a very broad differential diagnosis. The localisation of pain in one of the five anterior hip regions helps to establish a precise diagnosis and an adapted treatment. We review the differential diagnosis and treatment of anterior hip pain.
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PMID:[Differential diagnosis of groin pain]. 1827 63

Postoperative groin pain is a common complaint following surgery of the abdomen and groin. Although this pain usually resolves in the early postoperative period, some experience prolonged, debilitating pain lasting months to years. There is currently a lack of consensus as to the appropriate transition from medical to surgical management of these patients. A retrospective review of 19 consecutive patients with postoperative pain symptoms suspicious for neuropathic origin was undertaken. Neuromas or entrapment of 1 or more nerves was identified in all patients. Improvement of pain and quality of life was reported in 84%, with a minimum 1 year's follow-up. Average preoperative and postoperative pain was 7.6 and 1.2, respectively, a statistically significant reduction. This study confirms high success rates for patients surgically treated for chronic postoperative groin pain when proper selection criteria and appropriate surgical techniques are applied. A management approach is proposed and the surgical technique is described for treatment of these patients.
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PMID:Management of chronic postoperative groin pain. 1903 83

Obturator neuralgia (ON) presents with pain in the groin, medial thigh, and sometimes the medial aspect of the knee. The causes include trauma, obturator hernia, pelvic cancer, pelvic surgery, hip surgery, following pelvic fractures, endometriosis, retroperitoneal hematoma, pregnancy, and delivery. Ultrasound (US) guidance facilitates real-time imaging, identification of vascular structures, and improves patient comfort in situations where nerve stimulation can be unpleasant. This is a case report of ON successfully treated with US-guided steroid injection. A 55-year-old man was referred to the pain clinic with groin pain and allodynia in the medial thigh and knee following a fall. He had tried multiple other therapies and none of them provided significant relief. Using a 10-5-MHz multi-frequency, 38-mm linear array transducer, the obturator nerve was scanned in both longitudinal and transverse directions. Under real-time imaging 10 mg of medroxy-progesterone in a volume of 1 mL was injected. Following the injection, a small area of the medial side of knee was still tender to light touch. A second injection was placed inferiorly and provided pain relief for more than 5 months. This successful demonstration of US guidance in ON may further encourage US guidance in pain clinic interventions.
Pain Pract
PMID:Ultrasound-guided steroid injection for obturator neuralgia. 1850 24

We describe 4 patients pooled from our patient populations who presented with groin pain at different periods postoperatively after implantation of a metal-on-metal hip resurfacing. Each patient underwent exploratory surgery after radiographic imaging, hematologic testing, and microbiological assessment of joint aspirations failed to explain their symptoms. Samples of periprosthetic tissues revealed extensive amounts of lymphocytic infiltrates that were suggestive of an immunologic reaction. The patients obtained complete resolution of symptoms subsequent to revision surgery. The incidence of implant failures resulting from metal sensitivity is unknown owing to the difficulty in making a confirmed diagnosis. The possibility that this is the source of groin pain should be considered when other reasons for symptoms of pain and/or joint effusion in hips with metal-on-metal resurfacing arthroplasties have been discounted.
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PMID:Metal sensitivity as a cause of groin pain in metal-on-metal hip resurfacing. 1853 79

This retrospective file review outlines a case study of an 84 year-old man with a transtibial amputation for vascular disease who underwent an ipsilateral total hip replacement (THR). The question being addressed was how surgical techniques, rehabilitation processes and outcomes of joint arthroplasty would need to vary in a case of an ipsilateral dysvascular amputees. The surgery and associated rehabilitation was undertaken for groin pain, falls and reduced mobility due to mechanical osteoarthritis of the hip. The surgical technique and post-operative multidisciplinary rehabilitation is described in detail. Information on exercise regimes, length of stay and follow-up data on function, driving and pain management is presented. The literature is reviewed and all known cases of THR in amputees as well as data on survival of dysvascular amputees is presented. In light of advances in secondary prevention of vascular disease and cardiovascular surgical techniques, amputees with vascular disease may be living longer than they were 20 years ago. They may be beginning to experience the issues associated with aging such as osteoarthritis of the large joints. This case review and others in the literature may suggest that survival rates for vascular amputees be reviewed.
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PMID:Ipsilateral total hip arthroplasty in a dysvascular below-knee amputee for advanced hip osteoarthritis: A case report and review of the literature. 1856 83

The objective was to retrospectively examine whether a manual therapy technique is effective in the treatment of chronic adductor-related groin pain in athletes. Thirty-three athletes with chronic adductor-related groin pain were approached. Thirty patients gave their consent to participate in the study. Patient satisfaction, return to activity and numeric pain score were recorded. Patients were treated after prewarming of the muscles; one hand is used to control the tension in the adductor muscles and the other hand is used to move the hip into abduction and external rotation. This flowing, circular motion stretches the adductor muscle group. The movement is repeated three times in one treatment session. Twenty-five out of 30 (83%) athletes reported a good or excellent satisfaction. Twenty-seven out of 30 (90%) athletes had resumed sport at (15/30) or below (12/30) their previous level of activity. The pain score for during or after activity decreased significantly from 8.7 to 2.2 after the treatment (P<0.01). This study shows that the manual therapy treatment might be a promising treatment for chronic adductor-related groin pain in athletes.
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PMID:A manual therapy technique for chronic adductor-related groin pain in athletes: a case series. 1869 35


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