Aching groin pain

by S. Thompson
(Canada)


I have an aching groin pain that is quite a bit better after some physio sessions. He first diagnosed me with tightness or impingement of my iliopsoas muscle but now says I have osteoarthritis. Two completely different ideas? He now says he doesn't need to see me as often. Can those two diagnoses be similar?

Three years ago had appendix cancer with multiple organs removed. The deep throbbing groin pain started a couple of months after surgery but gradually decreased in severity.

Recently I experienced a severe pain which felt like a nerve pain going from my groin are down my leg and wrapped around my knee. I could not put any weight on that leg. That is what brought me to the physiotherapist.

Could the surgery have affected my iliopsoas or is this more likely osteoarthritis? I am in my late sixties. I am very active and fit for my age with no weight problems.

I also have tight hip flexors and more limited movement in the right hip.

Dear S
Obviously with your complex history there are lots of ifs and buts; since I cannot examine you, what follows is clearly pure speculation.

Tight hip flexors and limited movement of the hip calls in the first instance for an x-ray of the pelvis. The likelihood of hip arthritis is high with the possibility of cancer in the pelvis demanding a consideration. The radiograph would answer this conundrum.

If you lie on your back and pull your knee to the chest, make a circle and drop it into the lotus position, is it much stiffer and more painful that the left hip? Hip arthritis to be confirmed by x-ray.

Throbbing pain in the groin invites questions too of a vascular condition. Blood pressure? Pain in the leg with walking relieved by rest? Smoker? Intermittent claudication. Has anyone tested the pulses in your leg?

Hip arthritis classically typically radiates down the thigh towards the knee. But yes there are a host of possibilities including sacroiliac joint subluxations and a femoral nerve problem.

My recommendation: start with an x-ray of your pelvis. Let me know the result.

Dr B

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