From the Guidelines
Groin pain in children is most commonly caused by conditions such as testicular torsion, torsion of the testicular appendage, and epididymoorchitis, which account for approximately 85% to 90% of cases. These conditions can be medical emergencies, and prompt diagnosis is essential to prevent complications. According to the study by 1, the acute scrotum is a medical emergency defined as scrotal pain, swelling, and redness of acute onset, and comprises at least 0.5% of all emergency department visits. The study also highlights that torsion of a testicular appendage, epididymitis, and testicular torsion are the three most common causes of acute scrotal pain.
Some key causes of groin pain in children include:
- Testicular torsion, which is a surgical emergency with a bimodal distribution presenting more frequently in neonates and postpubertal boys than in adults
- Torsion of the testicular appendage, which is the most common etiology in prepubertal boys
- Epididymoorchitis or epididymitis, which is the most common cause of acute scrotum in adolescent boys and adults
- Inguinal hernias, which can present as a bulge in the groin area when abdominal contents protrude through a weakness in the abdominal wall, as discussed in the study by 1
It is crucial for parents to seek medical evaluation if their child experiences persistent groin pain, especially if accompanied by swelling, fever, or difficulty walking, as prompt diagnosis ensures appropriate management and prevents complications. The study by 1 emphasizes the importance of rapid accurate diagnosis to appropriately triage potentially surgical and irreversible conditions from patients for whom conservative management is sufficient.
From the Research
Causes of Groin Pain in Children
The causes of groin pain in children can be varied and may include:
- Musculoskeletal injuries such as adductor strains and osteitis pubis 2
- Sports hernia, also known as athletic pubalgia 3, 4
- Groin disruption 2
- Iliopsoas bursitis 2
- Stress fractures 2
- Avulsion fractures 2
- Nerve compression 3, 5
- Snapping hip syndrome 2
- Bernhardt-Roth syndrome 3
- Meralgia paraesthetica 3
Sports-Related Pathologies
Sports-related pathologies are a common cause of groin pain in children, particularly those who participate in sports such as football, rugby, ice hockey, running, and ballet 6, 5, 4. These pathologies can include:
- Injuries to the hip and pelvis 5
- Injuries to the proximal femora 5
- Pelvic tendon attachments 5
- Pelvic musculature 5
Diagnostic Evaluation
A comprehensive diagnostic evaluation is necessary to determine the cause of groin pain in children. This may include: