Evaluation of the Causes of Groin Pain in Orthopedic Outpatient Practice

Background: Groin pain is a diagnostically complex clinical issue due to the region’s anatomical intricacy and the convergence of musculoskeletal, neurological, and visceral systems. Although traditionally associated with athletes, groin pain is prevalent in general outpatient populations and is often underdiagnosed or misattributed due to overlapping symptoms and variable presentation. This study aimed to investigate the clinical characteristics and underlying etiologies of groin pain among patients presenting to outpatient clinics. Aim of the study: To provide a comprehensive understanding of the patterns and factors contributing to groin pain, which improved the diagnostic and therapeutic strategies in outpatient clinical settings. Methods: A cross-sectional observational study was conducted at Basrah Teaching Hospital over 12 months (June 2024–June 2025). Ninety-nine patients presenting with groin pain to outpatient and emergency departments were evaluated through comprehensive clinical assessments, physical examinations, laboratory testing, and radiological imaging. Patients with confirmed gynecological, urological, or gastrointestinal causes were excluded. Results: The cohort included (54) 54.5% females and (45) 45.5% males out of 99 patients, with a mean age of 39.14±20.71 years. Groin pain was predominantly unilateral (78.8%), moderate to severe in intensity (93.9%), and frequently radiated to the thigh (56.6%) or knee (25.3%). Common aggravating factors included weight-bearing and physical activity. Mechanical signs, especially the “C sign” (71.7%), were frequently observed. Imaging identified fractures (24.2%), while provisionally the most common cause of groin pain among the patients was fractures (26.26%). This was followed by avascular necrosis (AVN) (15.15%), and disc prolapse (14.14%). Hernias and osteoarthritic (OA) changes each contributed to (10.1%). Muscle strain was noted in (7.07%), while hip dislocation was diagnosed in (5.05%). Less frequent causes included lipoma and mesenteric adenitis, each with (3.03%), and abscess, metastasis of tumors, and urinary stones, each with (2.02%). Conclusion: Groin pain in outpatient settings is multifactorial, with musculoskeletal and spinal etiologies predominating. The findings emphasize the need for structured, multidisciplinary diagnostic protocols, particularly in non-athletic populations. Early imaging—especially MRI—and comprehensive clinical evaluation are crucial to accurate diagnosis and effective management. Broader epidemiological research and long-term follow-up are recommended to refine diagnostic strategies and therapeutic interventions.