The orthopedic perspective on groin pain: The native and prosthetic hip

Orthopedic surgeons commonly evaluate groin pain. While many times the cause of the pain is the hip joint itself, extra-articular musculoskeletal conditions need to be carefully considered. Accurate history-taking, physical exam findings, and radiographs help distinguish between intra-articular and extra-articular pathology. It is also critical to entertain a broad variety of diagnoses across multiple fields. Discussing cases in person with a specialist, in particular a pelvic or abdominal surgeon, is often helpful when the diagnosis is unclear. Groin pain in a patient with a native hip is worked up differently than after a hip replacement. Interpreting plain radiographs and advanced imaging studies of a prosthetic hip require a set of skills that is unfamiliar to most radiologists and many general orthopedists. Chronic pain after a hip replacement needs to be worked up by an experienced revision surgeon.