GROIN PAIN

GROIN PAIN: Excerpt from Differential Diagnosis in Primary Care

The anatomic components of the groin consist of the skin, subcutaneous tissue, fascia, lymph nodes, the femoral nerve, arteries and veins, and underneath, the hip bones. With these components in mind, it should be easy to develop a differential diagnosis of groin pain because most of the lesions are inflammatory or traumatic.

GROIN PAIN

The skin is affected by intertrigo, scabies, furuncles, and herpes zoster, among other things. The subcutaneous tissue may be involved by cellulitis and a tuberculous abscess. When the fascia is weak or torn, femoral or inguinal hernias develop. More likely causes of groin pain are inflamed lymph nodes that may be from any venereal disease (such as gonorrhea or chancroid) or infections of other portions of the genitalia. The femoral nerve may be affected by viral neuritis, diabetic neuropathy, and disease of the spine (fracture, disc, or tumors). The femoral artery may be involved by a thrombosis, embolism, or dissecting aneurysm, whereas the vein may be thrombosed. Finally, the underlying hip bones can be involved by any form of arthritis, and infections or metastatic tumors of the bone. Fractures and other traumatic disorders affect the bones of the hip also.

It would be a gross omission if referred pain to the groin were not considered. Pain may be referred to the groin in pyelonephritis, renal colic, regional ileitis, appendicitis, salpingitis, and many other abdominal disorders.

Approach to the Diagnosis

In the approach to the diagnosis of groin pain, a mass or tender structure is usually present in the groin. If the mass is a lymph node, careful examination of the genitalia and lower extremities will often show the cause, but a urethral or vaginal smear and culture may be necessary to show gonorrhea. Investigation of the genitourinary (GU) tract and the GI tract for causes of referred pain is then undertaken, if the mass is reducible a hernia is likely and referral to a surgeon is in order. Incarcerated hernias, of course, demand immediate referral.

Other Useful Tests

1. Tuberculin test
2. Sonogram (cystic mass)
3. Flat plate of abdomen (hernia with intestinal obstruction)
4. X-ray of hip (fracture, osteomyelitis)
5. CBC (abscess)
6. Bone scan (tumor, osteomyelitis)
7. Angiogram (aneurysm)
8. Phlebogram (saphenous varix)
9. Exploratory surgery (hernia, tumor)
10. Biopsy (tumor)
11. CT scan (tumor, abscess)

Book Source Details

• Book Title: Differential Diagnosis in Primary Care
• Author(s): R. Douglas Collins
• Year of Publication: 2007
• Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.

More About Pain Disorder

• Back to disease: Pain Disorder: Introduction
• Next Book Extract About Pain Disorder: HAND AND FINGER PAIN (Differential Diagnosis in Primary Care)
• More Book Extracts: All Online Books for Pain Disorder

More Medical Textbooks Online about Pain Disorder

Review other book chapters online related to Pain Disorder:

Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Differential Diagnosis in Primary Care Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2007 ISBN: 0-7817-6812-8

 » Next page: HAND AND FINGER PAIN (Differential Diagnosis in Primary Care)

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

• HAND AND FINGER PAIN (Differential Diagnosis in Primary Care)
• HIP PAIN (Differential Diagnosis in Primary Care)
• HYPOGASTRIC PAIN (Differential Diagnosis in Primary Care)
• Breast pain [Mastalgia] (Handbook of Signs & Symptoms (Third Edition))
• Abdominal pain (Handbook of Signs & Symptoms (Third Edition))

Tools & Services:

• Bookmark this page
• Symptom Search
• Symptom Checker
• Medical Dictionary
• Give your feedback

Medical Articles:

• Disease & Treatments Search
• Misdiagnosis Center
• Full list of interesting articles

Forums & Message Boards

• Ask or answer a question at the Boards:
• I cannot get a diagnosis. Please help.
• Tell us your medical story.
• Share your misdiagnosis story.
• What is the best treatment for my condition?
• See all the Boards.

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com

Common Health Mistakes

Symptom
Checker

Search Specialists by State and City