Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • acute pain related to trauma
  • hx of sports-related or overuse injury
  • positive anterior impingement test (FADIR test)
  • pain on adduction against resistance (neutral hip flexion)
  • pain on palpation of adductor tendons
  • pain on palpation of iliopsoas

Other diagnostic factors

  • pain on passive range-of-motion testing of the hip joint
  • snapping/clicking hip
  • positive Trendelenburg's test
  • positive apprehension test
  • positive modified Thomas' test
  • pain on palpation of inguinal canal
  • pain on palpation of conjoined tendon at pubic tubercle
  • decreased strength and increased pain with hip flexion against resistance (90˚)
  • night pain/rest pain

Risk factors

  • previous groin injury
  • female sex
  • training background
  • age and sports experience
  • overweight
  • decreased range of motion of the hip
  • muscle strength

Diagnostic investigations

1st investigations to order

  • plain x-rays (AP pelvis and AP and lateral hip)
Full details

Investigations to consider

  • ultrasound of the hip
  • MRI of the hip
  • MRI arthrogram of the hip
  • CT of the hip
  • isotope bone scan of the hip
  • intra-articular injection corticosteroid ± local anaesthetic agent
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Orthopedic Surgery and Chief Surgeon

Sports Orthopedic Research Center – Copenhagen (SORC-C)

Arthroscopy Centre Hvidovre, Department of Orthopedics

Amager & Hvidovre Hospital

University of Copenhagen

Denmark

Disclosures

PH is an author of a number of references cited in this monograph. PH declares that he has no other competing interests.

Dr Per Hölmich would like to gratefully acknowledge Dr Cedric J Ortiguera and Dr Juan M Raposo, the previous contributors to this monograph. CJO and JMR declare that they have no competing interests.

Peer reviewers VIEW ALL

Specialist in Arthroscopy of the Shoulder, Hip, and Knee; Traditional and Reverse Shoulder Replacement; and Sports Medicine

Southern California Orthopedic Institute

Van Nuys

CA

Disclosures

CG declares that he has no competing interests.

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