Puck to Pubalgia: Imaging of Groin Pain in Professional Hockey Players

Abstract

Hockey is one of the fastest and most aggressive team sports, with great potential for injury. Groin injuries are common (5%e7% of all ice hockey injuries), can occur without contact, and account for a game loss of 25 player games per team per year in the National Hockey League (NHL) [1]. Injury data from the NHL revealed that 13e20 per 100 players per year sustained groin injuries [2]. These injuries are also seen in the amateur athlete, although they are often more severe in professional hockey players because of increased stresses and continued play despite injury. The groin is a complex anatomical region where 3 major body areas (abdomen, pelvis, and lower limbs) meet. Groin pain in athletes has multiple etiologies that are not often clinically apparent, some of which are classified under the term ‘‘athletic pubalgia’’ [3]. Athletic pubalgia is a clinical syndrome that may take on numerous forms and variations but primarily includes refractory unilateral or bilateral groin pain exacerbated by activity [4]. Chronic groin pain in athletes may also be of hip joint etiology, particularly secondary to femoral-acetabular impingement seen in this age group. Without proper diagnosis and treatment, these injuries may become chronic and even career threatening. The ability of magnetic resonance imaging (MRI) to depict anatomy and soft-tissue characteristics has proven useful in the evaluation of patients with groin pain [5,6]. It can be helpful in detecting the location of injury as well as delineating among muscular, tendinous, periosteal bony, and chondral injuries. We describe the magnetic resonance (MR)