From the Research
Diagnosis of inguinal ligament disruption requires a combination of clinical examination and imaging studies, with MRI being the gold standard for confirmation, as it can directly visualize the ligament and any associated soft tissue injuries 1. The evaluation should begin with a thorough history focusing on mechanism of injury, such as sports trauma, falls, or motor vehicle accidents.
- Physical examination findings typically include:
- Localized pain in the groin area
- Tenderness along the inguinal ligament (which runs from the anterior superior iliac spine to the pubic tubercle)
- Possible swelling, bruising, and pain with hip flexion or abdominal muscle contraction
- Range of motion testing of the hip may elicit pain, particularly with movements that stress the ligament Imaging studies are essential for confirmation, with
- Ultrasound being useful as an initial screening tool due to its accessibility and lower cost
- CT scans helping to identify any associated bony avulsions
- X-rays typically being normal in isolated ligament injuries but able to rule out fractures Differential diagnosis should include
- Sports hernia
- Adductor strain
- Hip labral tear
- Osteitis pubis Early diagnosis is important as missed injuries can lead to chronic pain and functional limitations, particularly in athletes who place significant stress on this anatomical region 2. The most recent and highest quality study suggests that laparoscopic surgery is the mainstay for non-responsive inguinal disruption treatment, with a recurrence rate of 2.5% and 98.5% of active patients returning to full sport activity at 9 months 1.