Athlete with chronic groin pain (sports hernia / athletic pubalgia)
Recommended: MRI Pelvis (dedicated athletic pubalgia protocol) is the preferred imaging study for athlete with chronic groin pain (sports hernia / athletic pubalgia). Spectrum of injuries: rectus abdominis-adductor aponeurosis, pubic symphysis stress, adductor tendinopathy.
Recommended study
MRI Pelvis (dedicated athletic pubalgia protocol)
Spectrum of injuries: rectus abdominis-adductor aponeurosis, pubic symphysis stress, adductor tendinopathy.
If the default doesn't apply
Dynamic / hernia evaluation
US
Dynamic Ultrasound (Valsalva)
No contrast
Watch-outs
FAI coexists frequently
Image hips; treating only groin without addressing FAI may have limited results.
Pearls
- 'Secondary cleft' sign: contrast extension in symphysis indicates pubic plate injury.
- Rectus-adductor aponeurosis tear is the classic 'sports hernia' lesion.
- Treatment: PT, injections, mesh repair / pelvic floor repair surgery.