Herniography in athletes with groin pain

Area of Science:

• Sports Medicine
• Diagnostic Imaging
• Surgical Diagnosis

Background:

• Groin pain is a common complaint among athletes, often with unclear etiology.
• Traditional physical examination has limitations in diagnosing hernias in athletes.
• Herniography offers a potential imaging solution for persistent athletic groin pain.

Purpose of the Study:

• To evaluate the diagnostic value of herniography in athletes presenting with groin pain.
• To determine the prevalence of hernias in symptomatic and asymptomatic groins in this population.
• To assess the correlation between herniographic findings and operative diagnoses.

Main Methods:

• Herniography was performed on 78 athletes (101 groins) experiencing groin pain between 1974 and 1981.
• Physical examination for hernia palpation was conducted prior to herniography.
• Surgical repair was performed on selected patients, with outcomes assessed post-operation.

Main Results:

• Hernias were detected in 84.2% of symptomatic groins and 49.1% of asymptomatic groins via herniography.
• Pre-operative palpation identified hernias in only 7.9% of painful groins.
• Herniographic and operative diagnoses showed strong correlation; direct hernias were common in athletes under 30.
• 69.8% of operated athletes were cured, and 20.6% improved; tenoperiostitis was a frequent alternative diagnosis.

Conclusions:

• Herniography is a valuable tool for diagnosing hernias in athletes with groin pain, significantly improving patient selection for surgical intervention.
• A comprehensive differential diagnosis is essential, considering conditions like tenoperiostitis, especially in non-operative or treatment-failure cases.
• The study highlights herniography's effectiveness in identifying occult hernias contributing to athletic groin pain.