The groin triangle

Published Online First: 19 November 2008. doi:10.1136/bjsm.2007.042259
British Journal of Sports Medicine 2009;43:213-220

Copyright © 2009 BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine.

Occasional piece

The groin triangle: a patho-anatomical approach to the diagnosis of chronic groin pain in athletes
EC Falvey, A Franklyn-Miller and P R McCrory

Dansk: Kroniske lyske smerter er en almindelig set skade i sportsfysioterapi og sports medicin. De er oftest et problem i de sportsgrene, der involverer sparke og dreje bevægelser under løb. Forekomsten af og fravær fra sport på grund af lyske smerter bør ikke undervurderes og  overgås kun af fravær på grund af frakturer og ACL rekonstruktioner. Uden en klar klinisk / patologisk diagnose, er den efterfølgende forvaltning af kroniske lyske smerter vanskelig. På grund af kombinationen af kompleks anatomi og den ikke-specifikke karakter af både tegn og symptomer bliver den diagnostiske proces problematisk. I denne artikel foreslås en ny pædagogiske model, der bygger på pato-anatomiske koncepter. Anatomiske referencepunkter er udvalgt til at danne en trekant (lyske, gluteus region og trochanter major) og giver udgangspunkt for undersøgelsen og differentiel diagnosticering og danner dermed grundlag for efterfølgende undersøgelse.

Engelsk: Chronic groin pain is a common presentation in sports medicine. It is most often a problem in those sports that involve kicking and twisting movements while running. The morbidity of groin pain should not be underestimated, ranking behind only fracture and anterior cruciate ligament reconstruction in terms of time out of training and play. Due to the insidious onset and course of pathology in the groin region it commonly presents with well-established pathology. Without a clear clinical/pathological diagnosis, the subsequent management of chronic groin pain is difficult. The combination of complex anatomy, variability of presentation and the non-specific nature of the signs and symptoms make the diagnostic process problematical. This paper proposes a novel educational model based on patho-anatomical concepts. Anatomical reference points were selected to form a triangle, which provides the discriminative power to restrict the differential diagnosis and form the basis of ensuing investigation. This paper forms part of a series addressing the three-dimensional nature of proximal lower limb pathology. The 3G approach (groin, gluteal and greater trochanter triangles) acknowledges this, permitting the clinician to move throughout the region, considering pathologies appropriately.