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

4. Chief Complaint of Groin Pain: How
to Take and Document a Specific Groin
Pain History, Exam, and What Studies
to Order
Jacob A. Greenberg
Editor’s Comment (BPJ)
The chief complaint of groin pain is serious. Surgeons who perform
inguinal hernia repairs should develop a thorough understanding of the
neuro and musculoskeletal anatomy of the inguinal region so that the history
provided by a patient in pain can be expertly matched to a focused
pain physical exam. A patient with a complaint of groin pain and a simultaneous
inguinal hernia should not automatically be told that the pain is
absolutely from the inguinal hernia until a thorough pain physical exam
has been performed and documented. Some patients with chronic pain
complaints after inguinal hernia repairs have undiagnosed sport injuries
that were misdiagnosed as an inguinal hernia, and this situation is absolutely
preventable by increasing awareness. Repairing a hernia in a
patient with a sports injury risks ongoing pain complaints, excessive office
visits and associated costs, and worst of all, an unsatisfied patient. This
thorough chapter clearly explains how to take and document a proper history
and physical on a patient whose chief complaint is groin pain.
Introduction
When the patient’s chief complaint is “pain” in the groin, surgeons
need to have an established routine to proceed with a proper evaluation.
This routine is very different than if the complaint was for a simple
© 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_4
27