Core Muscle Injury: Adductor Longus-related Injury

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Core Muscle Injury: Adductor Longus-related Injury

Authors, Editors, Case Information Author: Jaime Dougherty, BS Affiliation: Rowan-Virtua School of Osteopathic Medicine Co Author(s): Altamash Raja, DO, RMSK, CSCS Senior Editor: Laura Mattson, DO Clinical Vignette: A 27-year-old male presented with 6 weeks of right medial groin pain after barbell back squatting. He felt a pull in his groin at the bottom of the squat with deep hip flexion. Since then, he had pain with running and cutting as well as with daily activities like urinating, changing positions in bed, and coughing. Type of Probe Used: Linear Transducer 15-4 MHz Unlabeled Short Axis View of the Right Adductor Tendon Origin Unlabeled Short Axis View of the Right Adductor Tendon Origin Labeled Short Axis View of the Right Adductor Tendon Origin Labeled Short Axis View of the Right Adductor Tendon Origin with clear disruption of the common adductor tendon origin at the pubic symphysis with marked cortical irregularity Unlabeled Long Axis View of the Right Adductor Tendon Origin Unlabeled Long Axis View of the Right Adductor Tendon Origin Labeled Long Axis View of the Right Adductor Tendon Origin Labeled Long Axis View of the Right Adductor Tendon Origin with clear disruption of the common adductor tendon origin at the pubic symphysis. Specifically, the deep fibers of the adductor longus tendon were disrupted, characterized by a large anechoic region measuring approximately 1.87 x 1.56 x 0.55cm. The superficial tendon fibers appeared intact. Unlabeled Long Axis View of the Right Adductor Tendon Origin with Doppler Unlabeled Long Axis View of the Right Adductor Tendon Origin with Doppler Unlabeled Long Axis View of the Right Adductor Tendon Origin with Doppler Labeled Long Axis View of the Right Adductor Tendon Origin with Doppler. Subtle hyperemia and significant cortical irregularity noted. #7 - Video View Video Unlabeled Short Axis Cine of the Right Adductor Longus from Distal to Proximal with clear disruption of the common adductor tendon origin at the pubic symphysis with marked cortical irregularity. Interpretation Image Interpretation: A clear disruption of the common adductor tendon origin was appreciated at the pubic symphysis with marked cortical irregularity. Specifically, the deep fibers of the adductor longus tendon were disrupted, characterized by a large anechoic region measuring approximately 1.87 x 1.56 x 0.55cm. The superficial tendon fibers appeared intact. Subtle hyperemia and significant cortical irregularity were also noted at the adductor tendon origin and sonopalpation reproduced the patient's pain. The distal rectus abdominus tendon was intact. The pubic aponeurotic plate was intact. Impression: Near complete tear of the adductor longus tendon origin measuring approximately 1.56 x 0.55 x 1.87 cm without avulsion. Teaching Pearl: Core muscle injury is a broad term that includes injuries to muscular structures between the chest and mid-thigh, and anatomic classification around the pubic bone provides diagnostic clarity. For adductor longus-related injury, ultrasound should evaluate the common adductor-rectus aponeurosis, adductor longus origin, pubic cortex, and adjacent adductor musculature. The report should specify whether the injury involves tendon, fibrocartilage, aponeurosis, muscle, or adjacent adductors, and should estimate tear extent and retraction. These details can influence prognosis, rehabilitation, and the need for surgical consultation. References: 1. Campbell R. Ultrasound of the athletic groin. Semin Musculoskelet Radiol. 2013;17(1):34-42. doi:10.1055/s-0033-1333912 2. Mulry TJ, Rodenhouse PE, Busconi BD. Core muscle and adductor injury. Clin Sports Med. 2021;40(2):323-338. doi:10.1016/j.csm.2020.12.001 3. Johnson R, Cooke C, Jones G, Isern-Kebschull J, Schilders E. Correlation between a 3-step MRI assessment and surgical findings in classifying pyramidalis-anterior pubic ligament-adductor longus complex injuries in 161 athletes: validation of application of the PLAC classification system. Am J Sports Med. 2025;53(12):2915-2923. doi:10.1177/03635465251368389
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Authors, Editors, Case Information

Unlabeled Short Axis View of the Right Adductor Tendon Origin

Labeled Short Axis View of the Right Adductor Tendon Origin

Unlabeled Long Axis View of the Right Adductor Tendon Origin

Labeled Long Axis View of the Right Adductor Tendon Origin

Unlabeled Long Axis View of the Right Adductor Tendon Origin with Doppler

Unlabeled Long Axis View of the Right Adductor Tendon Origin with Doppler

#7 - Video

Interpretation

UPCOMING EVENTS

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