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

8. Groin Pain Etiology: Hip- Referred
Groin Pain
Joshua C. Campbell and Guy D. Paiement
Introduction
The differential diagnosis for groin pain originating from the hip is
extensive and includes many disease processes, ranging from degenerative
to autoimmune and from traumatic to genetic. It is important for any
physician to have a working knowledge of these clinical entities since
the presenting symptom, namely, groin pain, overlaps with so many
specialties.
More than two-thirds of patients with an intra-articular hip pathology
will present with groin pain, and many other extra-articular processes
around the hip will present with similar distribution of pain with very
subtle or no differences [ 1 ]. History taking is hard detective work and
the physical exam is critical. An absolute prerequisite is a good knowledge
of not only hip anatomy but also the structures around this
articulation.
Anatomy Around the Hip
The bony architecture of the hip is important to both its function and
its durability. The normal acetabulum is anteverted 15° and abducted
approximately 45° in the coronal plane. The femoral neck is anteverted
approximately 15° relative to the condylar axis of the distal femur, and
the angle between the femoral neck and shaft is around 125° in adults [ 2 ].
This relationship is important to preservation of motion between bony
structures and the function of the soft tissue structures surrounding the
joint. Surrounding the acetabulum is the labrum , which increases the stability
of the hip joint through a suction seal effect. Recent biomechanical
© 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_8
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