From the Research
The test of choice to rule out an inguinal hernia is a physical examination performed by a healthcare provider, with ultrasound being the preferred imaging modality when additional testing is needed, as evidenced by a systematic review published in 2020 1. This examination typically involves visual inspection and palpation of the groin area while the patient is both standing and lying down. The provider will ask the patient to cough or strain while they place their finger in the inguinal canal to detect any bulging. Some key points to consider when evaluating inguinal hernias include:
- The history and physical examination are usually sufficient to make the diagnosis, as noted in a study published in 2013 2.
- Ultrasonography has emerged as a convenient imaging tool for diagnosing inguinal hernia due to its advantages, such as portability and absence of radiation, as discussed in a pictorial review published in 2022 3.
- Ultrasound is particularly useful for detecting non-palpable or occult hernias, and has high sensitivity and specificity for detecting inguinal hernias, as reported in a retrospective study published in 2018 4.
- In cases where ultrasound results are inconclusive or when complications are suspected, MRI or CT scans may be ordered, as suggested in a study published in 2020 5. The physical examination remains the first-line diagnostic approach because it is cost-effective, readily available, and sufficient in most cases to diagnose an inguinal hernia, especially when the hernia is reducible and visible during examination.