Differential diagnosis of a sports hernia in a high-school athlete.
METHODS
Resident's case problem.


BACKGROUND
Chronic anterior hip and groin pain is a growing concern among high-performance athletes. This manuscript enforces the need for physical therapists to remain current with its complex differential diagnosis, as it can be debilitating for the athlete and equally frustrating for the sports medicine team. This resident's case problem details the account of an 18-year-old high-school wrestler who presented to the high-school sports medicine team without physician referral. His chief complaint was chronic right anterior hip and groin pain, which had been variable in frequency and intensity for 3 years.


METHODS
A screening examination for serious underlying pathology was negative. After physical examination, it was determined that this individual had signs and symptoms consistent with a sports hernia. He was referred to a general surgeon who diagnosed him with a symptomatic inguinal hernia and later performed laparoscopic evaluation and treatment. The patient had a moderate-size indirect inguinal hernia sac, which was carefully dissected away from the remaining contents of the spermatic cord and was repaired with a Parietex mesh. At a 2-week postoperation follow-up, the patient was asymptomatic and cleared to return to wrestling and baseball without limitations.


CONCLUSIONS
This resident's case problem demonstrates the debilitating and often elusive nature of a sports hernia. It suggests that the diagnosis is not well understood and emphasizes the importance of a robust medical foundation for each member of the sports medicine team conducting athletic evaluations.
Unverzagt
Casey A
CA
Skyline Hospital Physical Therapy and Sports Medicine, White Salmon, WA, USA. caseyu@proaxistherapy.com
Schuemann
Teresa
T
Mathisen
Jeffrey
J
D000293:Adolescent; D003937:Diagnosis, Differential; D006119:Groin / Q000473:pathology*; D006552:Hernia, Inguinal / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D012574:Schools; D014952:Wrestling / Q000293:injuries*