Differential Diagnosis for Groin Pain in Children
Single Most Likely Diagnosis
- Muscle strain: This is the most common cause of groin pain in children, often resulting from overuse or trauma during sports activities, such as soccer or football. The pain is typically localized to the groin area and may be accompanied by swelling or bruising.
Other Likely Diagnoses
- Osteitis pubis: An inflammatory condition affecting the pubic bone and surrounding muscles, often seen in young athletes. It presents with groin pain that worsens with activity.
- Apophysitis (e.g., osteochondritis of the apophysis): Inflammation of the growth plates, common in pediatric patients. Conditions like Sever's disease (calcaneal apophysitis) or slipped capital femoral epiphysis can refer pain to the groin area.
- Hernias (inguinal or femoral): Although more common in adults, hernias can occur in children, causing groin pain, especially with coughing, straining, or heavy lifting.
Do Not Miss Diagnoses
- Testicular torsion: A medical emergency that requires immediate attention. It presents with sudden, severe groin pain that may radiate to the testicle, accompanied by nausea, vomiting, and abdominal pain.
- Epididymitis: Inflammation of the epididymis, which can cause severe groin pain, swelling, and redness of the scrotum. It's a significant diagnosis to consider due to potential complications like testicular abscess or infertility.
- Slipped capital femoral epiphysis (SCFE): A condition where the ball at the upper end of the femur (thigh bone) slips out of place. It's a hip condition that can present with groin pain and is an emergency due to the risk of avascular necrosis.
Rare Diagnoses
- Avascular necrosis of the femoral head: Although more common in certain contexts (e.g., steroid use, sickle cell disease), it can occur in otherwise healthy children, leading to groin pain due to hip involvement.
- Psoas abscess: A rare condition where an abscess forms in the psoas muscle, which can cause groin pain, fever, and difficulty walking.
- Osteomyelitis or septic arthritis of the hip: Infections of the bone or joint, respectively, which are rare but serious conditions that can present with groin pain among other symptoms like fever and limited mobility of the hip.