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Table 2.

Differential diagnosis for extra-articular causes of groin pain in athletes.

Common extra-articular pathologies causing groin pain
Conditions Findings Related references
1. Muscle strain/tears
  • Aching groin or medial thigh pain and may or may not relate a specific inciting incident.

  • Painful restriction of movements especially adduction.

  • Localised tenderness and focal swelling along adductors.

  • Decreased adductor strength.

[57, 58]
2. Stress fracture
  • Exercise induced pain in hip, groin, thigh or referred to knee that aggravates at night.

  • Sudden worsening of groin pain suggests completion of fracture.

[5963]
3. Osteitis pubis
  • Anterior hip pain radiating to suprapubic area.

  • Localised tenderness over pubic symphysis.

[57, 64, 65]
4. Sports hernia
  • Insidious onset of groin pain on activity.

  • Pain aggravates on sudden movements like coughing, sneezing, kicking and sprints.

[2, 15, 66, 67]
5. Snapping syndromes
  • Groin pain that aggravates on movements.

  • Intermittent catching, locking of hip.

[64]
6. Nerve entrapment
  • Groin pain associated with burning sensation.

  • Altered sensation along the distribution of nerve.

  • Weakness of affected group of muscles.

[30, 68]

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