Best Practice Case Studies-Case 111 Asset 4 Athletic Pubalgia

Video Transcription

Video Summary

Doug Hoffman and Ryan Cruz initiate the new season of their Ultrasound Case Series, focusing on protocol-based ultrasound exams for common sports medicine problems. Ryan presents a detailed case of an 18-year-old soccer player with worsening left medial groin and hip pain linked to a rectus adductor aponeurosis injury. The presentation emphasizes understanding complex regional anatomy, differentiating terms like athletic pubalgia, sports hernia, and core muscle injury, and focusing on precise anatomical structures rather than buzzwords. Ryan outlines his sonographic protocol: starting with the anterior hip joint, iliopsoas, rectus femoris, and adductor muscles, stressing the importance of complementary radiographs and sonopalpation to correlate imaging with symptoms. He highlights the challenges in visualizing the proximal adductor longus tendon and aponeurosis, demonstrating the identification of a partial thickness tear extending into the aponeurosis but sparing the rectus muscle. The discussion addresses patient positioning—preferring supine over frog-leg to minimize discomfort—and clothing management to optimize imaging. Both speakers advise against overusing terms like "sports hernia," instead encouraging detailed descriptive reporting and noting that terminology should be clarified according to findings. Doug adds that protocols may vary based on patient age and clinical suspicion and stresses starting imaging at the anterior hip, as hip pathology is sometimes the pain source. The session demonstrates a comprehensive, patient-tailored ultrasound approach to athletic groin pain, combining clinical insight and imaging precision.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 1

Topic Abdomen

Keywords

4th Edition

4th Edition, Case 1

Abdomen

ultrasound protocol

sports medicine

athletic groin pain

rectus adductor aponeurosis injury

sonographic imaging

sports hernia differentiation

patient positioning