- Skin
- Color: erythema, ecchymosis, white, black
- Trophic changes (altered hair growth, sweat production)
- Scars
- Cyanosis
- Swelling
- Muscle tone: atrophy, hypertrophy
- Deformity: asymmetry, rotation, amputation
- Areas of interest
- Lumps or swelling in the groin
- Pubic symphysis
Groin
GENERAL EXAM
INSPECTION
PALPATATION
- Loosely broken into regions
- Inguinal Ligament
- Pubic symphysis or tubercle
- Adductor muscle group
- Iliopsoas muscle
- Lump if present
- If present, characterize the nature and location
- Number of lumps (more than one suggests lymph nodes)
- Is it reducible? Worse with cough or valsalva?
- Is it pulsatile
RANGE OF MOTION / STRETCHING
- Passively stretch
- Adductors
- Hip Flexors
STRENGTH
- Abdominal flexion
- Hip Adduction
- Hip Flexion
Editor’s Commentary
- Serner et al reviewed 81 male athletes with acute groin pain and studied their exam findings1
- Adductor-related
- Clinical examination is accurate in locating acute injuries to the adductors, generally with an accuracy greater than 90% for the various adductor tests.
- Specific adductor examination tests (resisted outer range adduction, adductor stretch and the squeeze test in hip neutral position) individually provided ∼80% probability of predicting a positive MRI in the adductors.
- These adductor examination tests also provided a very high probability of predicting an accurate injury location.
- Hip Flexor-related
- Hip flexor pain provocation tests had poor ability to predict a positive MRI, and poor accuracy, roughly no better than a coin toss
- Importantly, absence of palpation pain in the adductors and hip flexors has the highest predictive value for ruling out acute injury in these structures, with an accuracy greater than 90%
OTHER
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