Thoracolumbar Syndrome
Fig. 43.1. T12–L1 thoracolumbar nerve root compression with referred pain. Physical Examination Physical exam begins with examination of the spine with the patient in a prone position. Lateral pressure on…
Sports Hernia with Adductor Tendonitis
Fig. 36.1. (a) T2-weighted axial oblique image of the pelvis demonstrating a cleft sign (arrow) just inferior to the pubic symphysis (PS); (b) T2-weighted sagittal image of the pelvis demonstrating…
Value-Based Clinical Quality Improvement for Chronic Groin Pain After Inguinal Hernia Repair
Traditional clinical research Value-based clinical quality improvement Intent Testing of hypotheses Improving value Traditional clinical research Clinical quality improvement Pro Con Comparison Pre-market FDA requirement Costly and lengthy…
Chronic Pelvic Pain in Women
Gynecologic Endometriosis Pelvic inflammatory disease, chronic endometritis, chronic salpingitis Pelvic congestion syndrome Ovarian remnant syndrome Residual ovary syndrome Vulvodynia Vulvar vestibulitis Vaginismus Urologic Interstitial cystitis/painful bladder syndrome Chronic urethritis Gastrointestinal…
Right Inguinal Hernia with Osteitis Pubis: A Case Report of Osteitis Pubis and Ipsilateral Inguinal Hernia
Fig. 41.1. Osteitis pubalgia on MRI. Fig. 41.2. Right inguinal hernia on MRI. Diagnosis While the reducible right inguinal hernia in this patient was obvious, the patient’s history and physical…
Patient with Groin Pain After a Lichtenstein Hernia Repair
Fig. 39.1. MRI anterior pelvis, non-contrast, with Valsalva and dynamic views demonstrated intact right inguinal hernia repair with no hernia recurrence. T2 axial view here shows intact flat onlay mesh…
Patient with Groin Pain After Open Inguinal Hernia Repair with Mesh
Fig. 38.1. Densely adherent small intestine to prior hernia mesh in retroperitoneal space. Due to the chronic, non-neuropathic nature of his groin pain, it was felt that all previous mesh…
Chronic Groin Pain Following Posterior Hernia Surgery
Fig. 16.1. The anatomy of posterior floor as viewed through a laparoscope. (a) Inferior epigastric vessels. (b) Genital branch of the genital–femoral nerve. (c) Genital–femoral nerve. (d) Lateral cutaneous nerve….
Perioperative Pain Management: Multi-modalities to Prevent Postoperative Chronic Pain
Fig. 14.1. Nociceptive pain pathway. Fig. 14.2. Comprehensive view of pain pathway with multimodal points of modulation. Multimodal Analgesics for Acute Pain Management There are multiple analgesics that can be…
The Orthopedic Perspective on Groin Pain: The Native and Prosthetic Hip
Fig. 17.1. Intra-articular hip pathology is excluded by painless hip rotation and a negative Stinchfield test. Lumbar Spine Disease Spine diseases, such as thoracolumbar discogenic pain at multiple levels or…
