Patient is progressed through a progressive addition of sports specific soccer drills so that by day 14 post-injury, he is fully released for game participation. On day 16 post-injury he remoes himself from a scrimmage, reporting the recurrence of groin pain. Prior to continuing, please develop a differential diagnosis and list each possible diagnosis in order of likelihood. Tenderness is most pronounced at the bony attachment of the hip adductors, and pain can be elicited with passive stretching or resisted adduction. Pain is often present at the onset of activity, with gradual improvement as exercise progresses.
Osteitis pubis represents inflammation of the symphysis pubis.
It is thought to be caused by repetitive motion and microtrauma of the symphysis, often as a consequence of running, jumping, or kicking. Stress fractures may occur in the pelvis or more commonly in the femur. They result from accelerated bone remodeling in response to repeated stress. Patients with genitourinary and systemic diseases will most often have associated findings on history and physical examination. Such questions should be included in a review of systems.