Adductus Disruptus: Acute Groin Pain In A Soccer Coach - Page #1

Author: James Smith, MD
Co Author #1: James Michael Smith, MD
Co Author #2: Jesse Deluca, DO
Co Author #3: Benjamin Potter, MD

Patient Presentation:
46-year-old male soccer coach presents with left anteromedial thigh and groin pain after a soccer injury.

A 46-year-old male active duty Naval Aviator and amateur soccer coach presented with a 1 week history of left anteromedial thigh and groin pain of acute onset after a non-contact injury accompanied by a pop and tearing sensation when reaching for a soccer ball with the contralateral leg in wide abduction. He was unable to continue participating in practice. Within 24 hours of injury swelling and bruising developed in the groin, extending to the mid-thigh. Pain at rest had mostly resolved after a week, but he still complained of pain with overreaching while walking, as well as weakness in the proximal thigh and a slight limp. He denied radiation of pain, numbness, prior hip or groin pain, joint stiffness, catching or snapping of the hip.

The patient is otherwise healthy with no regular medication or supplement use. Past medical and surgical history is significant only for right ACL rupture with surgical repair 5 years ago.

Physical Exam:
Inspection: Antalgic gait, hips appear symmetric without leg length discrepancy. No ecchymosis or edema
Palpation: Tender mass palpated in the left groin crease. No bony tenderness.
Passive ROM: Limited secondary to pain. Worse with abduction.
Active ROM: Painful resisted adduction and straight leg raise.
Strength: Greater than 50% decrease in adduction compared to unaffected leg.
Neurovascular: 2+ Dorsalis Pedis and Posterior Tibial, sensation intact in all lower extremity dermatomes.
Special Tests: FABER/FADIR negative.

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