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Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings

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Abstract

Objective

To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features.

Design and patients

MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) were independently reviewed by two radiologists masked to the clinical details. Symptom duration (median 6 months) and clinical side of severity were recorded. Anatomical areas in the pelvis were scored for abnormality (as normal, mildly abnormal or abnormal) and an overall assessment for side distribution of abnormality was recorded, initially without post-gadolinium sequences and then, 3 weeks later (median 29 days), the post-gadolinium sequences only. Correlation between radiological and clinical abnormality was calculated by Spearman’s correlation.

Results

Abnormal anterior pubis and enthesis enhancement significantly correlated with clinical side for both radiologists (both P=0.008). Abnormal anterior pubis and adductor longus enthesis oedema was significant for one radiologist (P=0.009). All other features showed no significant correlation (P>0.05). In the control cases there was no soft tissue abnormality but symphyseal irregularity was present (n=2). For both radiologists assessment of imaging side severity significantly correlated with clinical side for post-gadolinium (P=0.048 and P=0.023) but not non-gadolinium sequences (P>0.05).

Conclusion

The extent and side of anterior pubis and adductor longus enthesis abnormality on MR imaging significantly and reproducibly correlates with the athletes’ current symptoms in chronic adductor-related groin pain.

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References

  1. Taylor DC, Meyers WC, Moylan JA, Lohnes J, Bassett FH, Garrett WE Jr. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia. Am J Sports Med 1991; 19:239–242.

    CAS  PubMed  Google Scholar 

  2. Fredberg U, Kissmeyer-Nielsen P. The sportsman’s hernia—fact or fiction? Scand J Med Sci Sports 1996; 6:201–204.

    CAS  PubMed  Google Scholar 

  3. Fricker PA. Management of groin pain in athletes. Br J Sports Med 1997; 31:97–101.

    CAS  PubMed  Google Scholar 

  4. Karlsson J, Sward L, Kalebo P, Thomee R. Chronic groin injuries in athletes. Recommendations for treatment and rehabilitation. Sports Med 1994; 17:141–148.

    CAS  PubMed  Google Scholar 

  5. Renstrom P, Peterson L. Groin injuries in athletes. Br J Sports Med 1980; 14:30–36.

    CAS  PubMed  Google Scholar 

  6. Fricker PA, Taunton JE, Ammann W. Osteitis pubis in athletes. Infection, inflammation or injury? Sports Med 1991; 12:266–279.

    CAS  PubMed  Google Scholar 

  7. Hawkins RD, Hulse MA, Wilkinson C, Hodson A, Gibson M. The association football medical research programme: an audit of injuries in professional football. Br J Sports Med 2001; 35:43–47.

    Article  CAS  PubMed  Google Scholar 

  8. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport 1995; 27:76–79.

    CAS  PubMed  Google Scholar 

  9. Holt MA, Keene JS, Graf BK, Helwig DC. Treatment of osteitis pubis in athletes. Results of corticosteroid injections. Am J Sports Med 1995; 23:601–606.

    CAS  PubMed  Google Scholar 

  10. Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandlebaum BR. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group). Am J Sports Med 2000; 28:2–8.

    CAS  PubMed  Google Scholar 

  11. Albers SL, Spritzer CE, Garrett WE Jr, Meyers WC. MR findings in athletes with pubalgia. Skeletal Radiol 2001; 30:270–277.

    Article  CAS  PubMed  Google Scholar 

  12. Renstrom PA. Tendon and muscle injuries in the groin area. Clin Sports Med 1992; 11:815–831.

    CAS  PubMed  Google Scholar 

  13. Akermark C, Johansson C. Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 1992; 20:640–643.

    CAS  PubMed  Google Scholar 

  14. Lynch SA, Renstrom PA. Groin injuries in sport: treatment strategies. Sports Med 1999; 28:137–144.

    CAS  PubMed  Google Scholar 

  15. Verrall GM, Slavotinek JP, Fon GT. Incidence of pubic bone marrow oedema in Australian rules football players: relation to groin pain. Br J Sports Med 2001; 35:28–33.

    Article  CAS  PubMed  Google Scholar 

  16. Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet 1999; 353:439–443.

    Article  CAS  PubMed  Google Scholar 

  17. Sandmeier R, Renstrom PA. Diagnosis and treatment of chronic tendon disorders in sports. Scand J Med Sci Sports 1997; 7:96–106.

    CAS  PubMed  Google Scholar 

  18. Martens MA, Hansen L, Mulier JC. Adductor tendinitis and musculus rectus abdominis tendopathy. Am J Sports Med 1987;15:353–356.

    CAS  PubMed  Google Scholar 

  19. Williams P, Foster ME. “Gilmore’s groin”—or is it? Br J Sports Med 1995; 29:206–208.

    CAS  PubMed  Google Scholar 

  20. Ekberg O, Sjoberg S, Westlin N. Sports-related groin pain: evaluation with MR imaging. Eur Radiol 1996; 6:52–55.

    CAS  PubMed  Google Scholar 

  21. Orchard JW, Read JW, Neophyton J, Garlick D. Groin pain associated with ultrasound finding of inguinal canal posterior wall deficiency in Australian Rules footballers. Br J Sports Med 1998; 32:134–139.

    CAS  PubMed  Google Scholar 

  22. Kalebo P, Karlsson J, Sward L, Peterson L. Ultrasonography of chronic tendon injuries in the groin. Am J Sports Med 1992; 20:634–639.

    CAS  PubMed  Google Scholar 

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Acknowledgement

The authors would like to acknowledge the contribution Professor W.W. Gibbon made to the development of the initial MR imaging protocol.

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Correspondence to P. Robinson.

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Robinson, P., Barron, D.A., Parsons, W. et al. Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings. Skeletal Radiol 33, 451–457 (2004). https://doi.org/10.1007/s00256-004-0753-2

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  • DOI: https://doi.org/10.1007/s00256-004-0753-2

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