The Musculoskeletal System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
A hernia or rapture is the protrusion of any organ or body part through the muscular wall that should contain it. The most common are Inguinal hernias, so named because they occur in the inguinal region (the area of the groin), and they usually occur in males. Hiatal hernias develop from a defect in the diaphragm that allows part of the stomach to pass through an opening for the esophagus into the thoracic cavity. Femoral hernias just below the groin involve a portion of the bladder and peritoneum, most frequently in females. Umbilical hernias protruding at the naval are most common in newborns, obese females, and females following multiple pregnancies. An incisional hernia forms around an improperly healing surgical wound.
Solid organ transplantation
Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven in Succeeding in Paediatric Surgery Examinations, 2017
There are several classic postoperative complications following renal transplant. Lymphoceles are collections of lymphatic fluid resulting from division of lymphatic channels during iliac dissection. Most common symptoms include groin pain and leg swelling. Serum creatinine may be elevated if there is compression of the vasculature of renal collecting system. Lymphoceles are most common in retroperitoneal transplants where the lymphatic fluid is not absorbed by the peritoneal cavity. Delay in graft function is defined as the need for dialysis in the first week following transplant. This is seen with longer preservation times, older organ donors, technically difficult transplants and with postoperative recipient hypotension. Graft thrombosis is a rare complication following renal transplant. It is seen in recipients with hypercoagulable conditions, atherosclerotic vessels, or where technical problems occur during vascular anastomosis. Acute thrombosis presents as decreased urine output and increased serum creatinine. Acute pain over the graft and new onset haematuria can also be seen. Diagnosis is made by urgent ultrasound and correction is operative. Urine leak is often seen several days postoperative when swelling recedes or when the tip of the ureter that is most distant from the new vascular supply becomes ischaemic. Urine leaks often present as pain in the lower abdomen that can mimic appendicitis or other causes of peritonitis. Fluid can sometimes be seen on ultrasound and sampled percutaneously. Diagnosis is often made by the observation of extravasation during a MAG3 nuclear medicine scan.
Genital
A. Sahib El-Radhi in Paediatric Symptom and Sign Sorter, 2019
Swelling of the groin in infants and young children is common and usually noticed by the mother while giving the child a bath. Lymphadenopathy and inguinal hernia (IH) are the two most common causes. An important finding in this area is spermatic cord hydrocele, which is a fluid collection along the spermatic cord; it results from abnormal closure of the processus vaginalis and is separated from the testis and epididymis. It has two types: an encysted hydrocele, which does not communicate with the peritoneum, and a communicating hydrocele, where the fluid collection communicates with the peritoneum. Lymphadenopathy is mostly caused by local inflammation such as nappy rash. Groin pain often accompanies groin swelling, is caused by a tear or rupture to any adductor thigh muscles following trauma, and produces sudden sharp pain in the thigh. Other causes of groin pain include transient synovitis (irritable hip), hip avascular necrosis (Perthes’ disease) and hip arthritis.
Adductor injuries in the National Basketball Association: an analysis of return to play and player performance from 2010 to 2019
Published in The Physician and Sportsmedicine, 2020
Bhavik H. Patel, Kelechi R. Okoroha, Toufic R. Jildeh, Yining Lu, James D. Baker, Benedict U. Nwachukwu, Mitchell G. Foster, Answorth A. Allen, Brian Forsythe
Publicly available records and injury reports related to the NBA were reviewed from the 2009–2010 season to the 2018–2019 season. Sources for data acquisition included official team injury reports, press releases, and professional statistical and transactional online sources. Specific online sources utilized included the official website of the National Basketball Association (NBA.com) and official websites of each NBA team, as well as websites of several established sports media outlets including ESPN (ESPN.com), CBS (CBSsports.com), NBC (NBCsports.com), and Fox (FoxSports.com). Additionally, information was gathered from a professional sports analysis and statistics website (basketball-reference.com) and a transactional sports database (prosportstransactions.com). All instances of adductor injuries that occurred during the study period were tabulated. Events reported as ‘groin injury,’ ‘groin strain,’ or ‘groin tear’ were also investigated, and were only included if an adductor injury was confirmed. Each instance of suspected adductor injury was manually confirmed by cross-checking with official NBA injury reports. No instances of conflicting data were encountered during our review.
Long-standing groin pain in an elite athlete: usefulness of ultrasound in differential diagnosis and patient education – a case report
Published in European Journal of Physiotherapy, 2018
Kingsley S. R. Dhinakar, Anjanette Cantoria Lacaste
The definition of AP causing pubic pain has evolved since the initial definition by Hackney [5], who defined the AP as ‘a weakness of the posterior inguinal wall resulting in an occult (medial hernia)’. More recently, as listed in Table 1, aetiologies, causes and definitions more broadly include injuries to, or imbalance of the abdominal wall and adjoining musculature. The Doha agreement meeting in 2015 [1] encourages the use of groin pain in athletes. This classification system has three major subheadings, which is summarised in Table 2. These are the defined entities for groin pain (adductor-related, inguinal-related and pubic-related groin pain), hip-related groin pain and other causes of groin pain in athletes. In addition, groin pain can be described by the duration of injury as long-standing groin pain or acute groin pain.
Prevalence of asymptomatic radiological findings in the groin region: a systematic review
Published in The Physician and Sportsmedicine, 2020
Jonas Massa, Frederik Vanstraelen, Stijn Bogaerts, Koenraad Peers
To correctly diagnose these groin injuries, in addition to a thorough history taking and clinical examination, imaging (in particular ultrasound or MRI) is a frequently used tool to further specify the diagnosis. However, like Docking et al. concluded in their narrative review about imaging of tendinopathies, imaging does not tell the entire story [5]. Imaging needs to be placed in the context of the overall clinical picture. For example, tendon structure changes (e.g. fiber disorganization and neovascularisation) are radiologically diagnosed as ‘tendinosis’ [5], but tendinosis does not always have a clinical significance (‘tendinopathy’). Girish et al. showed that supraspinatus tendinosis on ultrasound of the shoulder was seen in 39% of asymptomatic men and subscapularis tendinosis in 25% [6]. Therefore, it is important that clinicians are aware of the occurrence of asymptomatic findings. Heerey et al. recently conducted a systematic review about the asymptomatic prevalence of hip-related pathologies [7]. They included 29 studies reporting on the prevalence of hip-related pathologies in their review, which identified moderate evidence of a labral tear prevalence of 54% (95% CI 41% to 66%) and a cartilage defect prevalence of 12% (95% CI 7% to 21%) in asymptomatic individuals.
Related Knowledge Centers
- Abdominal Wall
- ADDuctor Longus Muscle
- Hernia
- Pubic Tubercle
- Thigh
- Torso
- Body
- Medial Compartment of Thigh
- ADDuctor Muscles of The Hip
- ADDuctor Brevis Muscle