Adductor Pain
synonyms: adductor enthesis, adductor dysfunction, adductor longus dysfunction
Adductor Pain ICD-9
Adductor Pain Etiology / Epidemiology / Natural History
- More common in competitive athletes: football, hockey, soccer and rugby.
Adductor Pain Anatomy
- Adductor enthesis = fibrocartilaginous insertion of the adductor tendon on the pubic bone
Adductor Pain Clinical Evaluation
- Clinical criteria for the diagnosis of adductor dysfunction:
-tenderness localized to the adductor longus origin
-pain on passive stretching of the adductors
-pain on adduction of the thigh against resistance
- Pain in the adductor region.
- Must rule out sports hernia and hip joint pathology
Adductor Pain Xray / Diagnositc Tests
- Hip and pelvis views are normal
- MRI: STIR coronal, T1-weighted axial oblique, and T1-weighted post-intravenous gadolinium fat-suppressed axial oblique and sagittal sequences. (Robinson P, Skeletal Radiol. 2004;33:451)
Adductor Pain Classification / Treatment
- Initial treatment: rest, ice, NSAIDs, physiotherapy
- Normal MRI: Consider corticosteroid injection into the pubic enthesis (injection into the fibrocartilaginous insertion of the adductor tendon on the pubic bone). Injection performed with c-arm or ultrasound guidance. 21-gauge needle inserted into the pubic cleft and directed toward the adductor longus enthesis. The enthesis is located in the angle between the pubic crest and the pubic symphysis. The needle is first directed into the pubis and then moved a few millimeters into the fibrocartilaginous enthesis. Injection= triamcinolone acetonide (80 mg in 2 mL) with Marcaine (bupivacaine) 3 mL of a 0.5% solution.
- Abnormal MRI (enthesopathy): steriod injections generally not beneficial
Adductor Pain Associated Injuries / Differential Diagnosis
- osteitis pubis
- sports hernia
- femoracetabular impingement
- Acetabular labral tear
Adductor Pain Complications
Adductor Pain Follow-up Care
- closed and open-chain adductor strengthening and stretching exercises. May return to full sport activity one week after injetcion.
Adductor Pain Review References
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