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MRI investigation for groin pain in athletes: is radiological terminology clarifying or confusing?
  1. Adam Weir1,2,
  2. Philip Robinson3,4,
  3. Brian Hogan5,
  4. Andrew Franklyn-Miller6,7
  1. 1 Department of Sports Medicine, Aspetar Hospital, Doha, Qatar
  2. 2 Amsterdam Center of Evidence Based Sports Medicine (ACES), AMC, Amsterdam, The Netherlands
  3. 3 Department of Radiology, Leeds Teaching Hospitals, Leeds, UK
  4. 4 University of Leeds and NHIR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK
  5. 5 Department of Radiology, Sports Surgery Clinic, Dublin, Ireland
  6. 6 Centre for Health, Exercise and Sports Medicine (CHESM), University of Melbourne, Melbourne, Australia
  7. 7 Department of Sports Medicine, Sports Surgery Clinic, Dublin, Republic of Ireland
  1. Correspondence to Dr Adam Weir, Aspetar Hospital, Sports Medicine, Doha po box 29222, Qatar;{at}

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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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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.