Osteoarthritis of the hip: The patient's symptoms of aching pain in the groin that worsens with movement and improves with position changes, such as squatting, are classic for hip osteoarthritis. The pain is often referred to the groin due to the shared innervation of the hip joint and groin area.

Bursitis (e.g., iliopsoas or iliopectineal bursitis): Inflammation of the bursae around the hip can cause groin pain that worsens with movement, especially if the bursae are irritated by repetitive motion or direct pressure.
Tendinitis (e.g., iliopsoas or rectus femoris tendinitis): Similar to bursitis, inflammation of the tendons around the hip can cause pain in the groin area, especially with activities that involve hip flexion.
Stress fracture: A stress fracture in the femoral neck or pubic ramus could cause groin pain that worsens with weight-bearing activities and improves with rest.

Hip fracture (e.g., femoral neck fracture): Although less likely given the chronic nature of the pain, a hip fracture is a critical diagnosis to consider, especially in older adults or those with risk factors for osteoporosis. A fracture could cause severe pain and disability if not promptly treated.
Inguinal hernia: An inguinal hernia could cause groin pain, especially if the hernia is incarcerated or strangulated. This condition requires urgent surgical evaluation.
Ovarian torsion or other gynecologic emergencies: Although less common, ovarian torsion or other gynecologic conditions could cause acute groin pain and require immediate medical attention.

Avulsion fracture: A rare condition where a fragment of bone is pulled away by a tendon or ligament, which could cause groin pain.
Piriformis syndrome: Although more commonly associated with buttock and leg pain, piriformis syndrome could potentially cause referred pain in the groin area.
Neoplastic processes (e.g., bone or soft tissue tumors): Rarely, groin pain could be the presenting symptom of a tumor in the hip or surrounding soft tissues.