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Advances in the field of groin pain in athletes have long been hampered by the use of inconsistent and confusing nomenclature. This reflects a lack of clarity on whether pathology is clinically relevant and on differentiating between often multiple painful structures. In a systematic review of 72 studies, 33 different diagnostic terms were used1 to describe patient cohorts, often with similar clinical presentations.
Agreeing on clinical terminology
A thorough patient and injury history and standardised complete physical examination remain the cornerstone for diagnosing athletes with groin pain. The Doha agreement defined four clinical entities (pubic, adductor, iliopsoas and inguinal-related groin) while also highlighting the hip and other possible causes of groin pain.2 This agreement aimed to simplify the terminology used to classify/diagnose athletes with groin pain and to provide a standardised approach to physical examination. This approach uses the patient's ‘known’ pain to identify the specific involved clinical entity. However, not all papers published since have adopted the terminology recommended in the Doha agreement.
Lack of histological evidence for tissue pathology
There remains a lack of histopathological evidence to support the multiple pathological conditions implicated in groin pain. A single study examined …
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