Groin pain is a common symptom that occurs in both sporty people and in the general population. The causes can be varied and range from muscular problems to nerve irritation to serious diseases of the hip joint. The hip is often overlooked as the origin of the symptoms, although hip pathologies are often responsible for groin pain. In this comprehensive blog post, we will explain the anatomical nature of the hip joint in detail, show the relationships between hip pathologies and groin pain, discuss possible differential diagnoses and shed light on frequent misdiagnoses.

Anatomy of the hip joint

The hip joint (Articulatio Coxae) is a central joint of the human musculoskeletal system and connects the thigh bone (femur) with the pelvis (pelvis). It is a ball joint that enables high mobility in several directions and at the same time carries body weight.

Bone structures

The main bone structures of the hip joint are:

• Femurkopf : The spherical upper part of the thigh bone that fits into the hip pan.
• Acetabulum : The hip pan of the pelvis that takes up the femoral head.

These bony structures together form the hip joint and enable movements such as flexion, stretching, abduction, adduction and indoor and outdoor rotation.

Cartilage and cliff

The joint surfaces of the femoral head and acetabulum are covered with hyalino cartilage, which acts as a shock absorber and enables low -friction movements. In addition, the acetabulum surrounds a fiber cartilage structure, the labrum acetabular, which deepens the joint pan and contributes to the stability of the joint.

Bands and capsule

The hip joint is surrounded by a strong joint capsule that is reinforced by several ligaments:

• Ligamentum iliofemorale : runs from the intestinal pillar to femur and prevents an excessive extension of the hip joint.
• Ligamentum pubofemorale : connects the pubic bone to femur and limits the excessive abduction.
• Ischiofemorale ligamentum : stretches from the seat leg to femur and inhibits the interior rotation.

These ligaments ensure the stability of the hip joint and limit extreme movements.

Muscles

The movements of the hip joint are made possible by a variety of muscles:

• Flexors : Muscles like the Iliopsoas M. bend the hip joint.
• Extensors : The M. Gluteus Maximus stretches the hip joint.
• Abductors : Muscles like the M. Gluteus Medius lift the leg on the side.
• Adductors : Muscles like the Adductor Longus M. lead the leg to the middle of the body.
• Rotators : Muscles like the piriformis M. enable the bone to be rotated internally and outside.

A harmonious interplay of these muscles is essential for the functionality and stability of the hip joint.

Connection between hip pathologies and groin pain

Ground pain can often be attributed to diseases or injuries to the hip joint. This is due to the narrow anatomical and functional connection between the hip and strap. In the following, some frequent hip pathologies are presented that can cause groin pain.

Coxy arthrosis (hip arthrosis)

Coxy arthrosis refers to the degenerative wear of the hip joint, in which the articular cartilage is increasingly broken down. This leads to pain that are often located in the bar and can radiate into the thigh or knee. Typical symptoms are starting pain after phases of rest, stress pain and a limited mobility of the hip joint. Rest pain can also occur in the advanced stage.

Hip dysplasia

Hip dysplasia is an innate or acquired malformation of the hip joint, in which the acetabulum does not adequately cover the femoral head. This leads to an instability of the joint and can lead to pain and premature osteoarthritis in young adulthood. Grain pain is a frequent symptom, often accompanied by a feeling of instability or a "snap" in the joint.

Femoroacetabular Impingement (FAI)

The femoroacetabular impingement describes a clamping symptoms in the hip joint, which is caused by structural changes on the femoral head or on the acetabulum. A distinction is made between two main forms:

• CAM impingement : A deformity of the femoral head means that it no longer fits optimally into the hip pan. This leads to a mechanical conflict between femur and acetabulum, especially when bend and rotating movements.
• Pincer impingement : An overly pronounced hip pan leads to the clamping of the Labrum Acetabular and the adjacent joint structures.

Both forms of the FAI can cause groin pain that typically occur in sporting activities and intensify with long sitting or intensive stress. Untreated pinching can lead to cartilage damage and osteoarthritis in the long term.

Labrum lesions

The acetabular LABRUM is a cartilage that surrounds the acetabulum and increases the stability of the hip joint. Damage or a tear of the LABRUM can cause groin pain, which is often described as deeply sitting. Typical symptoms are "clicking" or "snapping" in the joint and movement restrictions.

Labrum lesions can arise from trauma, degenerative changes or as a result of a FAI. The diagnosis is usually carried out by a magnetic resonance imaging (MRI) with contrast medium.

Bursitis trochanterica

Inflammation of the bursa in the area of ​​the hip, in particular the Bursa Trochanterica, can lead to pain in the lateral hip area that can radiate into the bar. Typically, the pain is reinforced when pressure on the Major trochanter.

Differential diagnoses of groin pain

In addition to hip -related causes, there are numerous other diseases that can cause groin pain. This includes:

• Bentbruch (inguinal hernia) : A curb of abdominal organs due to a weak point in the abdominal wall can lead to stinging groin pain, especially when it comes to stress.
• Adductor problems : Muscle injuries or tendon irritation of the adductor muscles are often common in athletes and can go hand in hand with groin pain.
• Nerve compressions : An irritation of the femoral nerve or N. Obturatorius can cause neuropathic groin pain.
• Gastrointestinal causes : Diseases of the intestine, such as diverticulitis or appendicitis, can also imitate groin pain.

Frequent misdiagnoses for groin pain

Grant pain is often diagnosed incorrectly because the symptoms of different diseases overlap. The following misdiagnoses are particularly common:

• Misorial to a hip pathology as a hernia : Especially early signs of coxarthrosis or a FAI are often misinterpreted as inguinal hernia.
• Confusion with muscular problems : Adductor problems are often diagnosed, although there is a structural hip disease.
• Back problems as the cause : Sometimes a herniated disc or lumbar nerve root air conditioning is assumed as the cause of the groin pain, although the problem is in the hip.



Conclusion: groin pain often originated in the hip joint!

Grain pain is a complex symptom with a variety of causes. It is particularly important not to overlook the hip as possible origin of the symptoms. Careful diagnosis with clinical examination, imaging and, if necessary, interventional tests, is essential to make the right diagnosis and to initiate effective therapy. Especially in the case of persistent or unclear groin pain, hip -related causes should always be considered.

It is therefore advisable to consult a hip specialist early on in order to rule out serious illnesses and start targeted treatment. Early diagnosis can significantly improve the forecast and prevent long -term restrictions.