Cam morphology and inguinal pathologies: is there a possible connection?

Abstract

BackgroundTo analyse the prevalences of the cam and pincer morphologies in a cohort of patients with groin pain syndrome caused by inguinal pathologies.Materials and methodsForty-four patients (40 men and 4 women) who suffered from groin pain syndrome were enrolled in the study. All the patients were radiographically and clinically evaluated following a standardised protocol established by the First Groin Pain Syndrome Italian Consensus Conference on Terminology, Clinical Evaluation and Imaging Assessment in Groin Pain in Athlete. Subsequently, all of the subjects underwent a laparoscopic repair of the posterior inguinal wall.ResultsThe study demonstrated an association between the cam morphology and inguinal pathologies in 88.6% of the cases (39 subjects). This relationship may be explained by noting that the cam morphology leads to biomechanical stress at the posterior inguinal wall level.ConclusionsAthletic subjects who present the cam morphology may be considered a population at risk of developing inguinal pathologies.Level of evidenceLevel IV, Observational cross-sectional study.

Potential MRI findings associated with inguinal hernia and inguinal canal posterior wall weakness in athletes

“…In the present study, some MRI findings (ALT, CDP and BMO) are frequently associated with the presence of IH and ICPWW with an OR value respectively equal to 3.83, 3.77 and 3.68, respectively. They are an indirect evidence of mechanical overload stress both at symphysis (BMO and CDP) and tendon level (ALT and BMO) but also of symphysis intrinsic instability (CDP) 3,4,30,31 . Many studies show that mechanical stress at symphysis level can cause inguinal pathologies 4,37-39 , therefore the results of this study suggest that some MRI findings correlated with symphysis mechanical stress This study shows a high inter-observer reliability for the different US (range 1 -0.74) and RM (range 0.82 -0.61) findings, these values are in line with the data present in literature 22,23 .…”

“…Groin pain syndrome (GPS) can be caused by many clinical entities, including inguinal hernia (IH) [1][2][3] and inguinal canal posterior wall weakness (ICPWW) 3,4 . The inguinal canal posterior wall weakness is the presence of a bulging without signs of a "true" hernia and without the presence of a real hernia sac 3,4 .…”

“…Groin pain syndrome (GPS) can be caused by many clinical entities, including inguinal hernia (IH) [1][2][3] and inguinal canal posterior wall weakness (ICPWW) 3,4 . The inguinal canal posterior wall weakness is the presence of a bulging without signs of a "true" hernia and without the presence of a real hernia sac 3,4 . This condition is described in literature using different terms, like "Gilmore's groin" 5 , "incipient hernia" 6 , "hockey groin" 7 , "groin disruption" 8 , "inguinal disruption" 1 , "inguinal related groin pain" 2 , "sportsman's hernia" 9 , "sportsman's groin" 10 , "sport hernia" 11 .…”

“…Dynamic US shows a positive predictive value (PPV) between 91-100% for IH and ICPWW [14][15][16][17] . However, GPS may be caused by several clinical conditions 2,3,18 often each other associated 3,4,19,20 . Many of these clinical frameworks can be observed by MRI 11,18,[21][22][23][24][25][26][27][28][29][30][31] .…”

Ultrasound-guided Musculoskeletal Interventions for the Most Common Hip and Pelvis Conditions: A Step-by-Step Approach

“…40 This condition can be classified as adductor related, iliopsoas related, inguinal related and pubic related. [41][42][43] Osteitis pubis is an overuse syndrome characterized by pelvic pain and tenderness on deep palpation over the pubic symphysis usually involving the adductor group or gracilis muscles. 27 The typical symptoms include anterior and medial groin pain, exacerbated by pelvic motion, adductor stretching, perineal pain and testicular or scrotal pain.…”