Differential Diagnosis for Groin Pain

The following is a list of potential diagnoses for groin pain, categorized by likelihood and potential impact.

• Single most likely diagnosis

  • Muscle strain: This is often the most common cause of groin pain, typically resulting from overuse or direct injury to the muscles in the groin area, such as the adductor muscles. Activities that involve sudden stops, changes of direction, or kicking motions are common precipitating factors.

• 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.
  • Groin pulls or adductor tendonitis: Inflammation of the tendons that attach the adductor muscles to the bone, usually due to overuse or repetitive strain.

• 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 the blood supply to the testicle. It requires immediate attention to save the affected testicle.
  • Epididymitis or orchitis: Inflammation of the epididymis or testicle, often due to bacterial infection, which can lead to serious complications if not treated promptly.
  • Aortic dissection or abdominal aortic aneurysm: Although rare, these conditions can present with groin pain and are life-threatening emergencies requiring immediate medical intervention.

• Rare diagnoses

  • Avulsion fractures: A fracture where a fragment of bone is pulled away by a tendon or ligament, which can occur in the groin area.
  • Stress fractures: Small cracks in a bone, often due to overuse or repetitive stress, which can occur in the bones of the pelvis or femur and cause groin pain.
  • Psoas abscess: A collection of pus in the psoas muscle, which can cause groin pain and is often associated with underlying conditions such as osteomyelitis or spinal infections.
  • Nerve entrapment syndromes: Conditions where a nerve is compressed or irritated, such as obturator nerve entrapment, which can cause groin pain and other neurological symptoms.