Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

13. Imaging for Evaluation
of Groin Pain
Joseph M. Miller , Shane D. Smith , David N. Ishimitsu ,
and Rola Saouaf
While inguinal hernias can typically be diagnosed with a history
and physical examination alone, patients who present with atypical
symptoms or subtle examination findings may require one or more
imaging studies to determine the true cause of their pain. The high
prevalence of inguinal hernia among the general populace implies the
possibility that coincident pathology—whether musculoskeletal, neurologic,
urologic, or gynecologic—must be entertained as the true cause of
groin pain. Moreover, it is important to understand that patients with
classic symptoms of an inguinal hernia may have such a small defect as
to be practically undetectable on physical exam. Imaging diagnosis of
the so-called occult or hidden hernia is difficult, and is therefore given
focused attention at the end of this chapter. The radiologic evaluation of
patients with groin pain after herniorrhaphy presents unique challenges
and is detailed in a separate chapter.
Imaging Modalities
The four modern branches of imaging consist of computed tomography
(CT)/radiography (X-ray), magnetic resonance (MR), ultrasound
(US), and nuclear imaging . Each has their own strengths and weaknesses
with respect to the kinds of pathologies they can discriminate.
© Springer International Publishing Switzerland 2016
B.P. Jacob et al. (eds.), The SAGES Manual of Groin Pain,
DOI 10.1007/978-3-319-21587-7_13
173