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

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484 N.A. Al-Enazi and B.P. Jacob • Neurological—unremarkable • Genitourinary/renal—unremarkable • Musculoskeletal—unremarkable • Psychiatric—normal behavior Focused Examination BMI: 32 mg/kg 2 . Abdomen: soft and non-tender. Umbilicus: no hernias. Left groin: no obvious hernia on exam. Right groin: patient was examined in standing and lying position, with and without Valsalva maneuver. A small reducible right inguinal hernia was palpable when standing and coughing, and the patient did not have any discomfort over this reducible bulge. Right pubic bone and tubercle: mildly tender to palpation. Left pubic tubercle: non-tender. Symphysis: non-tender and stable to manipulation. Rectus muscle: when flexed during sit-up maneuver, mildly uncomfortable over right tubercle insertion site only. RIGHT Hip rotation: non-tender. RIGHT Leg elevation against resistance to evaluate the flexors (flexion at hip joint): mildly uncomfortable over the right tubercle with this maneuver. Reproducible symptoms. RIGHT Leg extension (extension at the hip joint): non-tender and no symptoms.RIGHT Adductor: mildly tender over the right tubercle inseriton with right leg adduction, reproducible symptoms.right groin pain with standing and squatting: NONE. RIGHT GROIN Sensory exam: no numbness, tingling, or hypersensitivity along any of the nerve distribution in the groins. rotation: non-tender. Leg elevation against resistance to evaluate the flexors: mildly uncomfortable over the right tubercle with this maneuver. Leg extension: non-tender. Adductor: mildly tender over the right tubercle with right leg adduction. Standing and squatting: non-tender. Sensory exam: no numbness, tingling, or hypersensitivity along any of the nerve distribution in the groins .
41. Right Inguinal Hernia with Osteitis Pubis… 485 Workup Magnetic resonance imaging ( MRI) of the osseous pelvis with attention to the pubic symphysis showed that there was mild marrow edema and subchondral remodeling at the pubic symphysis compatible with osteitis pubis (Fig. 41.1 ). The adductor tendons were intact. The rectus abdominis aponeurosis was intact as well. There was also a fat-containing right-sided inguinal hernia with direct and indirect component measuring 3 cm (Fig. 41.2 ). Diagnosis While the reducible right inguinal hernia in this patient was obvious, the patient’s history and physical examination gave high suspicion for the clinical diagnosis of osteitis pubis as well. The symptoms of osteitis pubis can be presented as any complaint in the groin or lower abdomen [ 1 ]. Pain generally is localized over the symphysis and may radiate to the groin, scrotum, perineum, medial thigh, hip, or abdomen [ 2 ]. Fig. 41.1. Osteitis pubalgia on MRI.
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Brian P. Jacob · David C. Chen Bru
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The SAGES Manual of Groin Pain Bria
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Foreword Inguinal hernia repair is
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Contents Part I Primary Groin Pain
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Contents ix 22 Management of Inguin
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Contents xi 45 Value-Based Clinical
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xiv Editors and Contributors Jeffre
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xvi Editors and Contributors David
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xviii Editors and Contributors Greg
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xx Editors and Contributors David S
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1. Introduction to Primary and Seco
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10 I.A. Gawlas and W.J. Peacock Ili
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12 I.A. Gawlas and W.J. Peacock Tra
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14 I.A. Gawlas and W.J. Peacock Var
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3. Complex Regional Pain Syndrome T
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4. Chief Complaint of Groin Pain: H
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4. Chief Complaint of Groin Pain…
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42 C. Ma and A. Ramaswamy inguinal
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44 C. Ma and A. Ramaswamy Categoriz
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46 C. Ma and A. Ramaswamy with no s
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48 C. Ma and A. Ramaswamy 26. Aasva
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50 I.M. Daoud and K. Dunn Other per
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52 I.M. Daoud and K. Dunn low herni
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54 I.M. Daoud and K. Dunn In the po
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56 I.M. Daoud and K. Dunn with a he
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58 I.M. Daoud and K. Dunn 13. O’C
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60 G.J. Mancini Occult Hernia Backg
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62 G.J. Mancini Magnetic resonance
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64 G.J. Mancini rocking motion can
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66 G.J. Mancini Unique to the adduc
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68 G.J. Mancini two nerve injuries
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70 G.J. Mancini abdominis has a rep
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72 G.J. Mancini 5. Light D, Ratnasi
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74 J.C. Campbell and G.D. Paiement
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9. Groin Pain Etiology: Spine and B
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10. Groin Pain Etiology: Spermatic
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Table 10.2. European Association of
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138 M. Hibner and C. Coyne Piriform
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140 M. Hibner and C. Coyne Fig. 11.
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142 M. Hibner and C. Coyne Table 11
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144 M. Hibner and C. Coyne present
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146 M. Hibner and C. Coyne Table 11
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148 M. Hibner and C. Coyne Once the
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150 M. Hibner and C. Coyne 3. Hibne
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12. Chronic Pelvic Pain in Women M.
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12. Chronic Pelvic Pain in Women 15
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174 J.M. Miller et al. Knowing the
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176 J.M. Miller et al. Fig. 13.2. A
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182 J.M. Miller et al. Fig. 13.9. C
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184 J.M. Miller et al. Fig. 13.14.
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192 J.M. Miller et al. Cardiac Cath
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194 B.J. Dunkin Noxious peripheral
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196 B.J. Dunkin Table 14.1. Summary
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198 B.J. Dunkin Rectus abdominis Ex
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200 B.J. Dunkin COX-1 COX-2 Celecpx
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202 B.J. Dunkin Table 14.2. Common
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204 B.J. Dunkin Possible Preoperati
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206 B.J. Dunkin Postoperative Pain
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208 B.J. Dunkin Summary Understandi
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15. Chronic Groin Pain Following An
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222 E.L. Felix not seem to alter th
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224 E.L. Felix nerves from the surg
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226 E.L. Felix Fig. 16.2. Lateral f
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228 E.L. Felix It has been establis
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230 E.L. Felix 18. Pollak R, Nyhus
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17. The Orthopedic Perspective on G
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246 J.F.M. Lange Jr. examination an
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248 J.F.M. Lange Jr. and remedial s
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250 J.F.M. Lange Jr. Best available
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252 J.F.M. Lange Jr. Neuropathic pa
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254 J.F.M. Lange Jr. This algorithm
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19. Radiologic Evaluation for Posto
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19 Radiologic Evaluation for Postop
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268 A. Malhotra extended variant of
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270 A. Malhotra steroid injections,
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272 A. Malhotra located just below
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274 A. Malhotra Nociceptive Acute N
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276 A. Malhotra 20. Rozen D, Parvez
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278 R. Álvarez intentionally or in
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Fig. 21.1. Material: A ballpoint pe
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Fig. 21.5. Dermatome mapping compat
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Fig. 21.9. Dermatome mapping compat
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286 R. Álvarez Subsequently, we mu
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288 R. Álvarez G : Granuloma H : H
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290 R. Álvarez Fig. 21.14. Same pa
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292 R. Álvarez 6. Lermite E, Arnau
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294 K.A. Seymour and J.S. Yoo Table
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296 K.A. Seymour and J.S. Yoo repro
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298 K.A. Seymour and J.S. Yoo Recur
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23. Mesh Removal for Chronic Pain:
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23. Mesh Removal for Chronic Pain
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320 I.T. MacQueen et al. inguinodyn
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322 I.T. MacQueen et al. Fig. 24.2.
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324 I.T. MacQueen et al. Timing and
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326 I.T. MacQueen et al. Fig. 24.4.
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328 I.T. MacQueen et al. Posthernio
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330 I.T. MacQueen et al. never be e
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25. Laparoscopic Triple Neurectomy
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26. Chronic Orchialgia: Workup and
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27. The Role of Bioactive Prostheti
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376 G. Campanelli et al. affecting
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378 G. Campanelli et al. into the w
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380 G. Campanelli et al. chronic gr
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382 G. Campanelli et al. A prospect
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384 G. Campanelli et al. open mesh
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386 G. Campanelli et al. 38. Alfier
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29. Prevention of Pain: Optimizing
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30. Prophylactic Neurectomy Versus
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Table 31.1. Selective neurectomy wi
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408 W.M.J. Reinpold and A.D. Schroe
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32. Chronic Groin Pain: Mesh or No
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Part IV Case Reports and Patients
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430 S. Towfigh were irregular and s
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Page 478 and 479: 482 S. Towfigh References 1. Matthi
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Page 486 and 487: 42. Patient with Chronic Pelvic Pai
Page 488 and 489: 42. Patient with Chronic Pelvic Pai
Page 490 and 491: 43. Thoracolumbar Syndrome James A.
Page 492 and 493: 43. Thoracolumbar Syndrome 497 The
Page 494 and 495: 43. Thoracolumbar Syndrome 499 Groi
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Page 526 and 527: 532 Index Athletic pubalgia (cont.)
Page 528 and 529: 534 Index Chronic post-herniorrhaph
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536 Index Groin pain (cont.) magnet
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538 Index Ilioinguinal nerve (IIN)
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540 Index Local anesthetics (cont.)
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542 Index Peripheral nerve entrapme
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544 Index S Sacroiliac (SI) joint d
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546 Index Transperineal pudendal ne
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Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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