| Superior to base | Rectus abdominis tendinopathy | Well localised to insertion, acute or insidious onset | Pain from resisted sit-up.10 41 Pubic “clock”: 12 | Magnetic resonance imaging11 |
| Incipient hernia; conjoint tendon tear | Insidious onset, diminished performance, warms up | Pain on resisted “torsion” of trunk “ipsilateral direction”.16 Pubic “clock”: 11 | Ultrasound17 |
| Incipient hernia; external oblique aponeurosis tear | Acute onset, related to sport-specific movement, eg, “slap shot”22 | Pain on resisted “torsion” of trunk “contralateral direction”16 | Magnetic resonance imaging18 |
| Tenderness and dilation of superficial inguinal ring on invagination of scrotum23 | Confirmation by direct vision at arthroscopy19–21 |
| Pubic “clock”: 12–1 | |
| Inguinal hernia | Pain on valsalva manoeuvre | Cough impulse, palpable mass at deep inguinal ring (direct), in inguinal canal/scrotum (indirect) | Ultrasound17 |
| Herniography,42 laparoscopy |
| Nerve entrapment | Altered skin sensation | Dysaesthesia/hyperaesthesia over area of skin supplied by nerve in question7 26 | Relief of pain by ultrasound-guided local anaesthetic infiltration27 |
| Ilioinguinal nerve |
| Iliohypogastric nerve | Nerve conduction studies7 |
| Genitofemoral nerve (genital branch) |
| Lateral femoral cutaneous nerve |