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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44. Patient with Referred Hip Pain Shirin Towfigh Chief Complaint Right groin pain, “like a tearing sensation at my groin crease.” History The patient is a 41-year-old male with chronic right groin pain. He has had a full workup at major academic institutions, including evaluation by gastroenterologists and pain management specialists, and has undergone colonoscopy, endoscopy, and injections, with no improvement in his pain. His main complaint is a tearing sensation at the right groin crease. It radiates from the groin to his anterior superior iliac spine (ASIS). It also radiates down his leg and into his thigh. He denies pain radiating around to his back or any hip pain. He admits that the pain is “deep” and not at the surface of his groin. The pain is worse with activities. It is not better when lying flat. He has pain when stepping into the car on the driver side. He also notes a hip click on that side. When the pain is at its peak, he walks with a limp to protect himself from the pain and prefers not to bear weight on that right leg. It is painful to lie on his right side. He prefers to lie on his contralateral side in fetal position. He denies groin bulge. He has no testicular pain. © 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_44 501
502 S. Towfigh Physical Exam No visible bulge or palpable hernia defect in the right groin. Nonspecific tenderness 2+ at the right groin, at the internal ring region. Non-tender ASIS, hip area, pubic bone. Pain with passive flexion and internal rotation of the right hip. Imaging Magnetic resonance imaging (MRI) of the pelvis was ordered to evaluate for inguinal hernia. It showed suggestion of hip anterior acetabular labral tear, with increased signal at acetabulum (Fig. 44.1 ), as well as CAMtype femoroacetabular impingement (FAI) . Diagnosis Right hip labral tear with FAI. Fig. 44.1. MRI of the pelvis, non-contrast, T2 axial view. Right anterior acetabulum with intermediate linear increased intensity signal, suggestive of labral tear ( yellow arrow ). Also, concomitant osseous bump at femoral head-neck junction suggestive of CAM-type femoroacetabular impingement ( yellow asterisk ). MR arthrogram is indicated.
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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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432 S. Towfigh in addressing her sy
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434 S. Towfigh Conclusion We have y
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436 K.W. Kercher Physical Examinati
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438 K.W. Kercher Fig. 34.4. Left ad
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440 K.W. Kercher Fig. 34.5. After d
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442 K.W. Kercher the posterior wall
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444 K.W. Kercher Table 34.2. Surgic
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35. Chronic Post-inguinal Herniorrh
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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
Page 498 and 499: 44. Patient with Referred Hip Pain
Page 500 and 501: 45. Value-Based Clinical Quality Im
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Page 526 and 527: 532 Index Athletic pubalgia (cont.)
Page 528 and 529: 534 Index Chronic post-herniorrhaph
Page 530 and 531: 536 Index Groin pain (cont.) magnet
Page 532 and 533: 538 Index Ilioinguinal nerve (IIN)
Page 534 and 535: 540 Index Local anesthetics (cont.)
Page 536 and 537: 542 Index Peripheral nerve entrapme
Page 538 and 539: 544 Index S Sacroiliac (SI) joint d
Page 540: 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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