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Groin pain

Última revisão: 14 Sep 2025
Última atualização: 10 Jun 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • acute pain related to trauma
  • history 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
Detalhes completos

Outros fatores diagnósticos

  • pain on passive range-of-motion testing of the hip joint
  • snapping/clicking hip
  • positive Trendelenburg 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
Detalhes completos

Fatores de risco

  • previous groin injury
  • higher level of play
  • reduced hip abductor and adductor strength
  • lower levels of training
  • increased age
  • decreased range of motion of the hip
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • plain radiographs (anteroposterior [AP] pelvis and AP and lateral hip)
Detalhes completos

Investigações a serem consideradas

  • 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 anesthetic agent
Detalhes completos

Algoritmo de tratamento

AGUDA

femoral neck stress fracture

traumatic or overuse injury: initial presentation

CONTÍNUA

traumatic or overuse injury: not responding to initial management

Colaboradores

Autores

Per Hölmich, MD, DMSc

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

Declarações

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

Agradecimentos

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

Revisores

Carlos Guanche, MD

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

Southern California Orthopedic Institute

Van Nuys

CA

Declarações

CG declares that he has no competing interests.

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Referências

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Principais artigos

European Society of Sports Traumatology, Knee Surgery and Arthroscopy. A formal ESSKA-EHPA-ESMA consensus: hip and groin pain in physically active adults. Oct 2024 [internet publication].Texto completo

Hölmich P. Adductor-related groin pain in athletes. Sports Med Arthrosc. 1997;5:285-291.

Hölmich P, Uhrskou P, Ulnits L, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomized trial. Lancet. 1999;353:439-443. Resumo

Artigos de referência

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