Comprehensive approach to the evaluation of groin pain

She wasn't born this way, but even Lady Gaga experienced groin pain-typically a symptom of hip disease such as arthritis of the hip-or, in her case, a hip labral tear. Groin pain is a common health complaint. According to a literature review appearing in the September 2013 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), one in four people develop hip arthritis-damage to the surfaces in the hip joint-before the age of 85 that contributes to groin pain.

Contributing factors to the development of hip arthritis and, subsequently, groin pain may include one or more of the following:

• a sports-related injury;
• prior surgery to the hip;
• infection of bone or soft tissue;
• a defect present at birth;
• problems with growth and development, and
• traumatic occupational and recreational history, bone fractures, or a history of trauma.

The specific symptoms, and the timing/onset of those symptoms, can help your doctor recommend the appropriate tests, imaging or referrals to diagnose and treat the cause of the pain.

"Individuals experiencing sudden, onset groin pain associated with trauma or bowel/bladder dysfunction, symptoms like fevers or abdominal discomfort should promptly seek medical attention," says Juan C. Suarez, MD, lead author of the study and an orthopaedic surgeon with Cleveland Clinic Florida. "But, those with chronic pain, despite time and conservative management, also warrant evaluation."

Young athletes participating in activities such as endurance sports, soccer, power lifting, ice hockey, and basketball are at an increased risk of developing hip osteoarthritis (OA), the "wear and tear" arthritis because of frequent, high stresses at the joint surface. In addition to hip arthritis, female athletes participating in endurance sports also are more likely to sustain hip and pelvic stress fractures than male athletes.

A detailed medical history and examination by a physician can help diagnose and manage the source of groin pain. "It is important to have a good network of physicians from multiple specialties," says Dr. Suarez. "In my experience, the diagnosis is not always obvious and it may require multiple visits, examinations and referrals prior to reaching the correct diagnosis. A good network facilitates this process."