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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J.C. Campbell and G.D. Paiement
Fig. 8.4. The Stinchfield test. The patient performs a forced straight- leg raise
against downward resistance at the thigh placed by the examiner. Pain in the
groin with this maneuver is considered positive.
Stinchfield test , which results in pain at the hip with resisted straight-leg
raise, is sensative however has low specificity (Fig. 8.4 ).
Diagnostic Exams The most useful radiological study is a standing
low anteroposterior (AP) pelvis (including both hips) with the patient
bearing weight equally on both sides (Fig. 8.5 ). A supine lateral radiograph
of the affected side (“frog leg lateral”) will complete the examination.
These two simple views will help to elucidate more than 90 % of hipreferred
groin pain originating from the bone. OA will have an obvious
appearance on plain x-rays, and no further imaging is needed to arrive at
this diagnosis (Fig. 8.6 ).
Differential Patients, especially young ones, with no obvious OA but
bony abnormalities should receive a consultation with an orthopedic
surgeon. Some of these pathologies can be treated early (e.g.,
impingement or hip dysplasia), leading to decreased rates of degeneration
about the hip.
Appropriate Treatment/Referral Osteoarthritis is very common, and
its first line of treatment is simple: nonsteroidal anti-inflammatory drugs
(NSAIDs), stretching, physical therapy (including pool therapy ), and
weight loss. Once these treatments have been exhausted, the patient
should probably be referred to a specialist. Steroid injection under
ultrasound or other imaging modalities should be considered if the pain