GROIN PAIN
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.
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 by 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
-
Tuberculin test
- Sonogram (cystic mass)
- Flat plate of abdomen (hernia with intestinal obstruction)
- X-ray of hip (fracture, osteomyelitis)
- CBC (abscess)
- Bone scan (tumor, osteomyelitis)
- Angiogram (aneurysm)
- Phlebogram (saphenous varix)
- Exploratory surgery (hernia, tumor)
- Biopsy (tumor)
- CT scan (tumor, abscess)
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
Other Book Chapters Related to Groin pain
Read excerpts from these other book chapters related to Groin pain:
Medical Books Excerpts
- HIP PAIN
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- Hip Pain
- "In A Page: Pediatric Signs and Symptoms" (2007)
- [ read ]
- HIP PAIN
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
- Hip Pain
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- HIP PAIN
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2008 Williams & Wilkins.
More About Causes of Groin pain
» Next page: Medications causing Groin pain
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