Abstract
OBJECTIVES: To investigate the prevalence of inguinal canal posterior wall deficiency (sports hernia) in professional Australian Rules footballers using an ultrasound technique and correlate the results with the clinical symptom of groin pain. METHODS: Thirty five professional Australian footballers with and without groin pain were investigated blind with a dynamic high resolution ultrasound technique for presence of posterior wall deficiency. RESULTS: Fourteen players had a history of significant recent groin pain and ten of these were found to have bilateral inguinal canal posterior wall deficiency (p < 0.01). The relative risk for a history of groin pain with bilateral deficiency was 8.0 (95% confidence interval 1.73 to 37.1). Groin pain was also found to be associated with increasing age (p < 0.01) which was an independent risk factor. Surgical, clinical, and ultrasound follow up for players who underwent hernia repair confirmed the validity of ultrasound as a diagnostic tool. CONCLUSIONS: Dynamic ultrasound examination is able to detect inguinal canal posterior wall deficiency in young males with no clinical signs of hernia. This condition is very prevalent in professional Australian Rules footballers, including some who are asymptomatic. There was a correlation between bilateral deficiency and groin pain, although the temporal relationship between the clinical and ultrasound findings is not established by the current study. Ultrasound shows promise as a diagnostic tool in athletes with chronic groin pain who are considered possible candidates for hernia repair.
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Selected References
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- Bradshaw C., McCrory P., Bell S., Brukner P. Obturator nerve entrapment. A cause of groin pain in athletes. Am J Sports Med. 1997 May-Jun;25(3):402–408. doi: 10.1177/036354659702500322. [DOI] [PubMed] [Google Scholar]
- Ekberg O., Blomquist P., Olsson S. Positive contrast herniography in adult patients with obscure groin pain. Surgery. 1981 May;89(5):532–535. [PubMed] [Google Scholar]
- Ekberg O. Complications after herniography in adults. AJR Am J Roentgenol. 1983 Mar;140(3):491–495. doi: 10.2214/ajr.140.3.491. [DOI] [PubMed] [Google Scholar]
- Ekberg O., Persson N. H., Abrahamsson P. A., Westlin N. E., Lilja B. Longstanding groin pain in athletes. A multidisciplinary approach. Sports Med. 1988 Jul;6(1):56–61. doi: 10.2165/00007256-198806010-00006. [DOI] [PubMed] [Google Scholar]
- Fredberg U., Kissmeyer-Nielsen P. The sportsman's hernia--fact or fiction? Scand J Med Sci Sports. 1996 Aug;6(4):201–204. doi: 10.1111/j.1600-0838.1996.tb00091.x. [DOI] [PubMed] [Google Scholar]
- Fricker P. A., Taunton J. E., Ammann W. Osteitis pubis in athletes. Infection, inflammation or injury? Sports Med. 1991 Oct;12(4):266–279. doi: 10.2165/00007256-199112040-00005. [DOI] [PubMed] [Google Scholar]
- Gibbs N. Common rugby league injuries. Recommendations for treatment and preventative measures. Sports Med. 1994 Dec;18(6):438–450. doi: 10.2165/00007256-199418060-00007. [DOI] [PubMed] [Google Scholar]
- Hackney R. G. The sports hernia: a cause of chronic groin pain. Br J Sports Med. 1993 Mar;27(1):58–62. doi: 10.1136/bjsm.27.1.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harrison L. A., Keesling C. A., Martin N. L., Lee K. R., Wetzel L. H. Abdominal wall hernias: review of herniography and correlation with cross-sectional imaging. Radiographics. 1995 Mar;15(2):315–332. doi: 10.1148/radiographics.15.2.7761638. [DOI] [PubMed] [Google Scholar]
- Kälebo P., Karlsson J., Swärd L., Peterson L. Ultrasonography of chronic tendon injuries in the groin. Am J Sports Med. 1992 Nov-Dec;20(6):634–639. doi: 10.1177/036354659202000603. [DOI] [PubMed] [Google Scholar]
- Lawrenz K., Hollman A. S., Carachi R., Cacciaguerra S. Ultrasound assessment of the contralateral groin in infants with unilateral inguinal hernia. Clin Radiol. 1994 Aug;49(8):546–548. doi: 10.1016/s0009-9260(05)82934-4. [DOI] [PubMed] [Google Scholar]
- Lichtenstein I. L., Shulman A. G., Amid P. K. The cause, prevention, and treatment of recurrent groin hernia. Surg Clin North Am. 1993 Jun;73(3):529–544. doi: 10.1016/s0039-6109(16)46035-4. [DOI] [PubMed] [Google Scholar]
- Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport. 1995 Sep;27(3):76–79. [PubMed] [Google Scholar]
- Malycha P., Lovell G. Inguinal surgery in athletes with chronic groin pain: the 'sportsman's' hernia. Aust N Z J Surg. 1992 Feb;62(2):123–125. doi: 10.1111/j.1445-2197.1992.tb00009.x. [DOI] [PubMed] [Google Scholar]
- Polglase A. L., Frydman G. M., Farmer K. C. Inguinal surgery for debilitating chronic groin pain in athletes. Med J Aust. 1991 Nov 18;155(10):674–677. [PubMed] [Google Scholar]
- Schumpelick V., Treutner K. H., Arlt G. Inguinal hernia repair in adults. Lancet. 1994 Aug 6;344(8919):375–379. doi: 10.1016/s0140-6736(94)91404-4. [DOI] [PubMed] [Google Scholar]
- Seward H., Orchard J., Hazard H., Collinson D. Football injuries in Australia at the élite level. Med J Aust. 1993 Sep 6;159(5):298–301. doi: 10.5694/j.1326-5377.1993.tb137863.x. [DOI] [PubMed] [Google Scholar]
- Simonet W. T., Saylor H. L., 3rd, Sim L. Abdominal wall muscle tears in hockey players. Int J Sports Med. 1995 Feb;16(2):126–128. doi: 10.1055/s-2007-972978. [DOI] [PubMed] [Google Scholar]
- Skandalakis J. E., Gray S. W., Skandalakis L. J., Colborn G. L., Pemberton L. B. Surgical anatomy of the inguinal area. World J Surg. 1989 Sep-Oct;13(5):490–498. doi: 10.1007/BF01658861. [DOI] [PubMed] [Google Scholar]
- Smedberg S. G., Broome A. E., Gullmo A., Roos H. Herniography in athletes with groin pain. Am J Surg. 1985 Mar;149(3):378–382. doi: 10.1016/s0002-9610(85)80112-4. [DOI] [PubMed] [Google Scholar]
- Taylor D. C., Meyers W. C., Moylan J. A., Lohnes J., Bassett F. H., Garrett W. E., Jr Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia. Am J Sports Med. 1991 May-Jun;19(3):239–242. doi: 10.1177/036354659101900306. [DOI] [PubMed] [Google Scholar]
- Truong S., Pfingsten F. P., Dreuw B., Schumpelick V. Stellenwert der Sonographie in der Diagnostik von unklaren Befunden der Bauchwand und Leistenregion. Chirurg. 1993 Jun;64(6):468–475. [PubMed] [Google Scholar]
- Zimmerman G. Groin pain in athletes. Aust Fam Physician. 1988 Dec;17(12):1046–1052. [PubMed] [Google Scholar]
