Ultrasound diagnosis for hip, groin and abdominal wall pain and/or lump
- ultrasound is also the first choice for investigating groin or abdominal wall hernias and for superficial lumps. Patients with these clinical complaints will be seen in a specialist musculoskeletal ultrasound clinic where the consultant or sonographer has special expertise in these particular examinations
- ultrasound can aid in the diagnosis by offering information on size, shape, location and appearance of superficial lumps with 'probe palpation', perfusion imaging and dynamic examination offering considerable advantage over MRI
- all superficial lumps that have any atypical features from the commonest pathologies, e.g. sebaceous cyst and lipoma, or which exhibit unusual size, require ultrasound analysis (especially before minor surgery in the primary care setting) as palpably soft lesions could well exhibit vascularity associated with more complex pathology, including malignant disease
Ultrasound diagnoses for hip, groin and abdominal wall pain and/or lump include:
- gluteal, hamstring and psoas enthesopathy
- psoas and ischial bursitis
- inguinal and femoral hernia
- Gilmore's groin (tear of conjoint tendon at external inguinal ring)
- Spigelian and paraumbilical hernia
- lipoma, lymphadenopathy
Notes:
Ultrasound applications
- Articular pain, swelling or mechanical symptoms without definitive diagnosis
- Shoulder pain or mechanical symptoms
- Symptoms near a joint
- Regional neuropathic pain to diagnose neural entrapment
- Guiding articular/periarticular aspiration or injection
- Diagnosis and treatment assessment of synovitis
Ultrasound advantages
- Cheaper, more accessible and better tolerated than MRI
- Preferred modality for tendinopathy and muscle trauma
- As accurate as MRI in diagnosis of rotator cuff tears
- Dynamic examination and intervention possible
Reference:
- 1) Arthritis Research UK (Summer 2013). Hands on - Musculoskeletal imaging for GPs.