Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete

Abstract

The nomenclature and the lack of consensus of clinical evaluation and imaging assessment in groin pain generate significant confusion in this field. The Groin Pain Syndrome Italian Consensus Conference has been organised in order to prepare a consensus document regarding taxonomy, clinical evaluation and imaging assessment for groin pain. A 1-day Consensus Conference was organised on 5 February 2016, in Milan (Italy). 41 Italian experts with different backgrounds participated in the discussion. A consensus document previously drafted was discussed, eventually modified, and finally approved by all members of the Consensus Conference. Unanimous consensus was reached concerning: (1) taxonomy (2) clinical evaluation and (3) imaging assessment. The synthesis of these 3 points is included in this paper. The Groin Pain Syndrome Italian Consensus Conference reached a consensus on three main points concerning the groin pain syndrome assessment, in an attempt to clarify this challenging medical problem.

Ultrasound-guided Musculoskeletal Interventions for the Most Common Hip and Pelvis Conditions: A Step-by-Step Approach

“…40 This condition can be classified as adductor related, iliopsoas related, inguinal related and pubic related. [41][42][43] Osteitis pubis is an overuse syndrome characterized by pelvic pain and tenderness on deep palpation over the pubic symphysis usually involving the adductor group or gracilis muscles. 27 The typical symptoms include anterior and medial groin pain, exacerbated by pelvic motion, adductor stretching, perineal pain and testicular or scrotal pain.…”

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

“…Groin pain syndrome (GPS) can be caused by many clinical entities, including inguinal hernia (IH) [1][2][3] and inguinal canal posterior wall weakness (ICPWW) 3,4 . The inguinal canal posterior wall weakness is the presence of a bulging without signs of a "true" hernia and without the presence of a real hernia sac 3,4 .…”

“…Groin pain syndrome (GPS) can be caused by many clinical entities, including inguinal hernia (IH) [1][2][3] and inguinal canal posterior wall weakness (ICPWW) 3,4 . The inguinal canal posterior wall weakness is the presence of a bulging without signs of a "true" hernia and without the presence of a real hernia sac 3,4 . This condition is described in literature using different terms, like "Gilmore's groin" 5 , "incipient hernia" 6 , "hockey groin" 7 , "groin disruption" 8 , "inguinal disruption" 1 , "inguinal related groin pain" 2 , "sportsman's hernia" 9 , "sportsman's groin" 10 , "sport hernia" 11 .…”

“…This condition is described in literature using different terms, like "Gilmore's groin" 5 , "incipient hernia" 6 , "hockey groin" 7 , "groin disruption" 8 , "inguinal disruption" 1 , "inguinal related groin pain" 2 , "sportsman's hernia" 9 , "sportsman's groin" 10 , "sport hernia" 11 . However, in according with the guidelines of Groin Pain Syndrome Italian Consensus Conference on Terminology, Clinical Evaluation and Imaging Assessment in Groin Pain in Athlete 3 , we prefer in this study to define this specific condition using the term of ICPWW. Both IH and ICPWW represent an important disability source and are often an important cause of time loss from sport activities in athletes 12,13 .…”

“…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] .…”