Pain in the right groin and medial side of the right thigh

Patrick's faber test

Patrick's faber test

I have been having severe pain in the right groin and medial side of the right thigh. I am a 40 year old female. The pain is sort of like a stabbing or burning pain. I have a bulged disc at L5S1 but as far as I understand the groin area is supplied by the L1 nerve. In the last MRI done a few months back they found a hemangioma on L1 but no bulging of the disc or no pinched nerve. Could this be causing the pain? What should I do about it?

Hello Sarah,
The question is whether the groin and inner thigh pain is cause by a pinched femoral nerve, or a hip joint problem.

The bulging L5S1 disc is probably irrelevant; an incidental finding.

Sacroiliac joint conditions also refer to the groin, so that should also come into the equation. Most unusual but it does happen is bone disease in the pubic rami. An x-ray would rule this out. Have you been pregnant recently by the way? That would be significant.

At 40 hip arthritis is uncommon, but its precursors, hip dysplasia and Femoral acetabular impingement syndrome would both produce these symptoms. Do you have a family history of hip problems?

Let's start with FAIS. Lie on your back and pull your left knee to the chest, to the opposite shoulder and then into the lotus position. This is called Patrick's faber test.

Now compare with the naughty hip. Is there any significant difference?

That hemangioma is unlikely to be the problem but it's right where we would be looking. If your partner presses hard in the upper lumbar area do you have significant tenderness?
Use a pin to prick the skin of the inner thigh, comparing sides. Is there any significant difference?

Let me know. Be as specific as you can. Have you had a pelvic x-ray?

Dr B



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