Introduction: Inguinal hernia and inguinal canal posterior wall weakness, are a frequent clinical issue in chronic groin pain syndrome. The gold standard imaging is represented by dynamic ultrasound (US), with a high positive predictive value in case of inguinal and sport hernia. However, it is important to consider that groin pain syndrome may be caused by several clinical conditions that often are detectable only with magnetic resonance (MRI) assessment. Methods: In an observational cross sectional study, 120 patients suffering from groin pain syndrome caused by inguinal hernia and/or inguinal canal posterior wall weakness diagnosed by clinical assessment and US examination, underwent a MRI protocol validated for pelvis and pubic area assessment. The same protocol was performed on a control group of 40 asymptomatic subjects. Results: Several MRI findings are strongly associated with the presence of inguinal hernia and/or inguinal canal posterior wall weakness. Conclusions: The presence of some specific MRI findings can make suspect the presence of inguinal hernia or inguinal canal posterior wall weakness. Level of evidence: Level IV. Observational cross sectional study.

Introduction: Traumatic groin pain syndrome can result from any acute trauma, but usually it is due to an indirect muscle injury (overstretching of the muscle fibers). The internal obturator muscle externally rotates the thigh and contributes to the stabilization of the hip joint. The indirect injury of this muscle may cause the onset of traumatic groin pain syndrome. Purpose: To perform a systematic review of the literature concerning the indirect injury of internal obturator muscle in relationship to the onset of groin pain syndrome. Conclusion: IO lesions are rare but important causes of traumatic groin pain syndrome, and despite their low incidence they must be considered during evaluation of patients with this pathology. Study design: Systematic review. Level of evidence: IV.