title: Diagnosis of Acute Groin Injuries: A Prospective Study of 110 Athletes.
abstract: BACKGROUND
  Acute groin injuries are common in high-intensity sports, but there are insufficient data on injury characteristics such as injury mechanisms and clinical and radiological findings.
  
  
  OBJECTIVE
  To describe these characteristics in a cohort of athletes.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  A total of 110 male athletes (mean age, 25.6 ± 4.7 years) with sports-related acute groin pain were prospectively included within 7 days of injury from August 2012 to April 2014. Standardized history taking, a clinical examination, magnetic resonance imaging (MRI), and/or ultrasound (US) were performed.
  
  
  RESULTS
  The most frequent injury mechanism in soccer was kicking (40%), and change of direction was most frequent in other sports (31%). Clinically, adductor injuries accounted for 66% of all injuries and primarily involved the adductor longus on imaging (91% US, 93% MRI). The iliopsoas and proximal rectus femoris were also frequently injured according to all examination modalities (15%-25%). Acute injury findings were negative in 22% of the MRI and 25% of the US examinations. Of the clinically diagnosed adductor injuries, 3% (US) and 6% (MRI) showed a radiological injury in a different location compared with 35% to 46% for clinically diagnosed iliopsoas and proximal rectus femoris injuries.
  
  
  CONCLUSIONS
  Adductor injuries account for the majority of acute groin injuries. Iliopsoas and proximal rectus femoris injuries are also common. More than 1 in 5 injuries showed no imaging signs of an acute injury. Clinically diagnosed adductor injuries were often confirmed on imaging, whereas iliopsoas and rectus femoris injuries showed a different radiological injury location in more than one-third of the cases. The discrepancy between clinical and radiological findings should be considered when diagnosing acute groin injuries.
authors.affiliation: Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark andreasserner@hotmail.com.
authors.forename: Andreas
authors.initials: A
authors.lastname: Serner
authors.affiliation: Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Johannes L
authors.initials: JL
authors.lastname: Tol
authors.affiliation: Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Nabil
authors.initials: N
authors.lastname: Jomaah
authors.affiliation: Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Adam
authors.initials: A
authors.lastname: Weir
authors.affiliation: Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Rodney
authors.initials: R
authors.lastname: Whiteley
authors.affiliation: Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Thorborg
authors.affiliation: Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Matthew
authors.initials: M
authors.lastname: Robinson
authors.affiliation: Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Hölmich
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D006119:Groin / Q000293:injuries*; D006801:Humans; D007869:Leg Injuries / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries*; D010808:Physical Examination; D011446:Prospective Studies; D012916:Soccer / Q000293:injuries; D013177:Sports; D013848:Thigh / Q000293:injuries; D055815:Young Adult
keywords: MRI; acute groin injuries; adductor; clinical examination; diagnosis; iliopsoas; injury mechanism; muscle strain; rectus femoris; ultrasound