"Superior cleft sign" as a marker of rectus abdominus/adductor longus tear in patients with suspected sportsman's hernia.
OBJECTIVE
We describe a new imaging sign, the "superior cleft sign", identified at both symphysography and MRI, which should be used as a marker of rectus abdominis/adductor longus attachment tearing.


METHODS
A study population of 25 patients presenting with clinically suspected sportsman's hernia, who had undergone both symphysography and MRI of the groin were included for study. In each case, images were reviewed to determine the presence of a superior cleft, secondary cleft, and or both abnormalities.


RESULTS
Images of all patients complaining of groin crease discomfort similar to sportsman's hernia revealed the presence of a superior cleft at the rectus abdominis/adductor longus attachment. This "superior cleft sign" correlated with the side of symptoms in each case, and, in contrast to the previously described secondary cleft along the inferior margin of the inferior pubic ramus, occurred parallel to the inferior margin of the superior pubic ramus.


CONCLUSIONS
The presence of the "superior cleft sign" should be sought in addition to the previously described secondary cleft sign in sportspeople presenting with exercise-related groin pain or pubalgia. It should specifically be sought in patients referred with suspected sportsman's hernia.
Radiology Department, Cappagh National Orthopaedic Hospital, Cappagh Road, Finglas, Dublin 11, Ireland. murphygrainne@gmail.com
Grainne
G
Murphy
Paul
P
Foran
Darra
D
Murphy
Oliver
O
Tobin
Michael
M
Moynagh
Stephen
S
Eustace
D000328:Adult; D001265:Athletic Injuries / Q000150:complications* / Q000473:pathology*; D006552:Hernia, Inguinal / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D017568:Rectus Abdominis / Q000293:injuries* / Q000473:pathology*; D015203:Reproducibility of Results; D012421:Rupture; D012680:Sensitivity and Specificity