Author: Ahmad Mostafavifar, MD
Co Author #1: A. Mehran Mostafavifar

Patient Presentation:
26 year old male soccer player felt acute pain and a pop in the left groin area during a professional soccer game.

History:
The patient sustained a non-contact injury after making a quick turn and sprinting after the ball. He immediately fell to the ground while holding his groin area. Following the injury, he was unable to continue play and had to be helped off the field. The player was otherwise healthy with no previous injuries to the area until two weeks prior to the injury when he began having mild discomfort in the left groin area that was not associated with any injury. He continued to play while taking NSAID's for pain, and using intermittent ice and electrical stimulation.

Physical Exam:
Hip/Groin
Gait was not examined secondary to pain. There was a 2 cm mass in the left groin area near the pubic symphysis. There was severe tenderness on palpation of the left pubic symphysis. There was no tenderness on palpation of the trochanter, ischial tuberosity, anterior superior iliac spine, or anterior inferior iliac spine. Internal and external rotation were normal bilaterally. There was pain with passive abduction and resisted adduction of left leg. There was mild pain with flexion of left leg but extension was pain free with a normal range

Lumbar Back
Full range of motion. No tenderness on palpation of spine, iliac crests, or posterior sacroiliac joint. Straight leg exam normal bilaterally.

Knee
Full range of motion. No tenderness on palpation. Lachman's test and posterior drawer test were normal. We were unable to perform McMurray's test due to groin pain. Apley's test was normal. Varus and valgus stress were normal.

Abdomen
Bowel sounds were present. Non-tender and non-distended. No hepatosplenomegaly. No masses.

Vascular
Dorsalis pedis and posterior tibial pulses 2+ bilaterally.

Neurologic
Sensory exam was normal. We were unable to examine motor strength due to groin pain. Reflexes were normal and Babinski's sign was absent.

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