Groin pain syndrome: an association of different pathologies and a case presentation

Abstract

Mini review- Case report (Level V).

Potential MRI findings associated with inguinal hernia and inguinal canal posterior wall weakness in athletes

“…In case of suspected presence of IH and ICPWW the gold standard imaging is represented by dynamic US 14 which shows a very high PPV [14][15][16][17] . This study has confirmed the multifactorial aetiology of GPS, and the overlapping of several clinical frameworks which is a common characteris-tic of LSGPS 3,4,19 . For this reason a standard MRI protocol can provide some important information concerning potential clinical entities correlated with the presence of IH and ICPWW.…”

“…Such long symptoms duration allows us to classify the GPS framework as "long standing GPS" (LSGPS or chronic GPS) in according with Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete 3 . In a LSGPS, the clinical framework is frequently based on the association of an inguinal pathology and a pubic osteitis (PO) 3,4,19 . It is important to remember that a PO framework is strongly associated with a chronic ALT 29,40 .…”

“…Moreover, Kunduracioglu et al 40 showed a relationship between SS severity degree and the chronicity of GPS in football players' population, suggesting that the severity of SS is in correlation to the duration of the GPS symptoms. However, it is important to underline the fact that signs of SS as well as cysts and osteophytes formation at symphysis level may be present also in asymptomatic athletes 31 depending on the sport activity and increasing in athletes practicing sports like football, tennis, hockey implying increase of the shear forces at symphysis level 19,[49][50][51] . For that reason, MRI findings of SS do not necessarily represent a lesion but can be considered more as an indirect sign of overuse at symphysis level.…”

“…Other limitation could be considered the limited size of CG and the different timing of MRI assessment. IH and ICPWW represent a frequent clinical framework in LSGPS 4,19,20,55 . In case of suspected presence of IH and ICPWW the gold standard imaging is represented by dynamic US 14 which shows a very high PPV [14][15][16][17] .…”

“…Dynamic US shows a positive predictive value (PPV) between 91-100% for IH and ICPWW [14][15][16][17] . However, GPS may be caused by several clinical conditions 2,3,18 often each other associated 3,4,19,20 . Many of these clinical frameworks can be observed by MRI 11,18,[21][22][23][24][25][26][27][28][29][30][31] .…”