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Comment & Response
June 10, 2020

Use of Sports Hernia to Describe Groin Pain in Athletes—Reply

Author Affiliations
  • 1Division of General and Trauma Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
  • 3Surgical Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
JAMA Surg. Published online June 10, 2020. doi:10.1001/jamasurg.2020.1767

In Reply We thank Thorberg and Hölmich for their critical evaluation of our recent narrative review1 on groin pain in athletes. Many valid points are raised as potential shortcomings in this article. First, we agree that these disease entities should not be termed sports hernia. Because this is a common misnomer that continues to be used and recognized by many, this term was included in the title to allow readers to recognize the subject material that was being described. We also concur that there are many different pathologies that contribute to the noncommittal and very general term groin pain syndrome. Broad, inclusive terminology may not be the most appropriate for nuanced care; however, it serves a useful role to categorize symptoms in the broader context of an overarching diagnosis. This can be useful for nonspecialists to make an all-encompassing diagnosis and then refer to appropriate clinicians for narrowing the diagnosis and initiation of specific treatments. We find that diagnosis recognition continues to be a challenge for groin pain, with many office visits and extensive workups often being initiated prior to the broader diagnosis being entertained. We wholeheartedly agree that common nomenclature is necessary to move the field forward and refine care. Moreover, we recognize the work of several consensus statements that have been put forth. This narrative review introduces more specific diagnoses and pathologies that contribute to the syndrome, including rectus abdominis-adductor longus pathology, inguinal disruption/canal pathology, inguinal neuralgia, or pubic symphysis disease.

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