Sadigale Omkar, Tiwari Anjali, Ramanathan Madhankumar, Choudhury Himanshu, Wadia Farokh, Bagaria Vaibhav
Department of Orthopaedic Surgery, Sir H. N. Reliance Foundation Hospital, Mumbai, Maharashtra, India.
Team Sports Physiotherapist Northamptonshire County Cricket United Kingdom, Northampton, England, United Kingdom.
J Orthop Case Rep. 2022 Feb;12(2):106-111. doi: 10.13107/jocr.2022.v12.i02.2688.
Traumatic groin pain (GP) is frequently the result of acute trauma, often an indirect muscle injury. The most affected muscles in traumatic GP are the rectus abdominis, adductors, and iliopsoas. The obturator internus bursitis as a cause of GP is very rare.
The present case describes a rare indirect injury of obturator internus bursitis in a 22-year-old male football player who reported GP that used to worsen with sprinting and change in directions. The pain was relieved with rest and sprinting at 80% capacity. The patient had been diagnosed clinically and on magnetic resonance imaging (MRI) as a case of obturator internus insertional tendinopathy with bursitis. His symptoms resolved after ultrasound-guided injection in the inflamed tendon sheath at its insertion point. After 2 years, the patient was followed up with a triumphant return to professional football with no recurrence and a good prognosis in a relatively short recovery time.
Clinical diagnosis of obturator injuries is often tricky. GP not responding to conservative management presents a unique challenge to the physician and the rehabilitation team. MRI must follow the radiological investigations and ultrasound if the reports were inconclusive of the diagnosis. In the present case study, the usual causes of such pain (osteitis pubis, and adductor muscle strains/tendinosis) were ruled out, and a specific unique condition was diagnosed with the help of the MRI.
创伤性腹股沟疼痛（GP）通常是急性创伤的结果，常为间接肌肉损伤。创伤性GP中受影响最严重的肌肉是腹直肌、内收肌和髂腰肌。闭孔内肌滑囊炎作为GP的病因非常罕见。
本病例描述了一名22岁男性足球运动员罕见的闭孔内肌滑囊炎间接损伤，该患者报告GP在短跑和改变方向时会加重。休息和以80%的能力进行短跑时疼痛会缓解。患者经临床诊断和磁共振成像（MRI）检查，被诊断为闭孔内肌插入性肌腱病伴滑囊炎。在炎症腱鞘的插入点进行超声引导注射后，他的症状得到缓解。两年后，对患者进行随访，其成功重返职业足球赛场，未复发，且在相对较短的恢复时间内预后良好。
闭孔损伤的临床诊断通常很棘手。对保守治疗无反应的GP给医生和康复团队带来了独特的挑战。如果放射学检查报告对诊断不明确，MRI必须作为后续检查，必要时结合超声检查。在本病例研究中，排除了此类疼痛的常见原因（耻骨炎和内收肌拉伤/肌腱病），并借助MRI诊断出一种特殊的独特病症。
