Sportsman's hernia

Background: Sportsman's hernia is a debilitating condition which presents a s chronic groin pain. A tear occurs at the external oblique which may resul t in an occult hernia. The definition, investigation and treatment of this condition remain unclear. Methods: A systematic Medline search was performed and all literature perta ining to chronic groin pain, groin injury, sportsman's hernia and sportsman 's groin from 1962 to 1999 was retrieved for analysis. Results: The costs of computed tomography and magnetic resonance imaging ar e such that their routine use for assessment of patients with groin pain ca nnot be justified. They may, however, be employed in difficult cases to hel p define the anatomical extent of a groin injury. Plain radiography, ultras onography and scintigraphy should be the usual first-line investigations to supplement clinical assessment. Herniography may help in situations of obs cure chronic groin and pelvic pain. There is no consensus view supporting a ny particular surgical procedure for sportsman's hernia. A number of report s have been published describing different repairs of the posterior inguina l wall deficiency. Appropriate repair of the posterior wall results in ther apeutic benefit in selected cases. Conclusion: The diagnosis of sportsman's hernia is difficult. The condition must be distinguished from the more common osteitis pubis and musculotendi nous injuries. Early surgical intervention is usually, although not always, successful when conservative management has failed.