Diagnosis of Acute Groin Injuries

Abstract

Background: Acute groin injuries are common in high-intensity sports, but there are insufficient data on injury characteristics such as injury mechanisms and clinical and radiological findings. Purpose: To describe these characteristics in a cohort of athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 110 male athletes (mean age, 25.6 ± 4.7 years) with sports-related acute groin pain were prospectively included within 7 days of injury from August 2012 to April 2014. Standardized history taking, a clinical examination, magnetic resonance imaging (MRI), and/or ultrasound (US) were performed. Results: The most frequent injury mechanism in soccer was kicking (40%), and change of direction was most frequent in other sports (31%). Clinically, adductor injuries accounted for 66% of all injuries and primarily involved the adductor longus on imaging (91% US, 93% MRI). The iliopsoas and proximal rectus femoris were also frequently injured according to all examination modalities (15%-25%). Acute injury findings were negative in 22% of the MRI and 25% of the US examinations. Of the clinically diagnosed adductor injuries, 3% (US) and 6% (MRI) showed a radiological injury in a different location compared with 35% to 46% for clinically diagnosed iliopsoas and proximal rectus femoris injuries. Conclusion: Adductor injuries account for the majority of acute groin injuries. Iliopsoas and proximal rectus femoris injuries are also common. More than 1 in 5 injuries showed no imaging signs of an acute injury. Clinically diagnosed adductor injuries were often confirmed on imaging, whereas iliopsoas and rectus femoris injuries showed a different radiological injury location in more than one-third of the cases. The discrepancy between clinical and radiological findings should be considered when diagnosing acute groin injuries.