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Groin pain in 37 year old woman

Exit forum ID Forum Discussion Groin pain in 37 year old woman

This topic contains 0 replies, has 1 voice, and was last updated by   William Brady, DC November 3, 2017 at 5:11 pm.

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    William Brady, DC
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      I have a patient that has come in off and on over the years with right sided groin pain.  Usually she has come in with other problems that have been more pressing than the leg so we haven’t dedicated significant time to diagnosing and fixing it properly (i.e. lumbar and disc pain, antalgia which we have worked through.  Her lumbar tests are all 90% or better at this point)

      She came in today saying that pain in the groin has gotten worse over the past month or two.  Is having quite a bit of pain after activity like walking or hiking to the point that she has a hard time walking the next day because of pain.  Also says that sitting in a car for more than an hour hurts her groin.

      Exam findings:

      SLR: 85* bilaterally, no symptoms

      SHF: thighs touch ribs bilaterally, right is stiffer than the left. She can feel some pull over the posterior thigh on the right.  I can feel adhesion in the more proximal adductor magnus which made that movement easier pretty quick.

      Passive abduction while she lays down hurts her visibly.  Palpating more superior around the adductor tendons is really painful to her.

      Resisted abduction hurt her at all.

      Squat: she can’t do it with the feet turned out 30* but isnt painful when they point forward.

      Lunge: knee adducts bilaterally, hip really juts out laterally on both sides.  Doesn’t have great force production at all pushing back up on either side.

      I’m thinking she has some pretty bad adductor tendinopathy of some sort.  I’d like some input on what sort of imaging we could order and also some differential diagnoses.  Again she says this has been a problem off and on for years now.

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