What is the cause of inguinal (groin) pain?

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Last updated: May 15, 2025View editorial policy

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Differential Diagnosis for Groin Pain

  • Single most likely diagnosis
    • Muscular strain: This is the most common cause of groin pain, often resulting from overuse or direct injury to the muscles in the groin area, such as the adductor muscles.
  • Other Likely diagnoses
    • Inguinal hernia: A protrusion of an organ or tissue through a weakened area in the groin, which can cause pain, especially when coughing, lifting, or bending.
    • Osteitis pubis: An inflammatory condition affecting the pubic bone and surrounding structures, often seen in athletes involved in sports that involve kicking or rapid changes of direction.
    • Hip or pelvic fractures: Fractures in the hip or pelvis can radiate pain to the groin area, especially if the fracture involves the femoral neck or acetabulum.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular torsion: A medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle, requiring immediate surgical intervention.
    • Aortic dissection or aneurysm: Although rare, aortic dissection or aneurysm can cause groin pain due to the proximity of the aorta to the groin area, and is a life-threatening condition.
    • Pulmonary embolism: In some cases, a pulmonary embolism can cause referred pain to the groin area, especially if the embolism is large and causes significant cardiovascular strain.
  • Rare diagnoses
    • Avulsion fractures: A rare type of fracture where a fragment of bone is pulled away from the main bone by a tendon or ligament, which can occur in the groin area.
    • Sports-related nerve entrapment: Nerve entrapment or compression can occur in the groin area, especially in athletes, causing pain, numbness, or tingling.
    • Referred pain from abdominal or pelvic pathology: Certain conditions, such as appendicitis, diverticulitis, or ovarian cysts, can cause referred pain to the groin area, although this is less common.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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