Abdominal hernias likely often occur with symptomatic FAI

LYON, France — Results from a retrospective study of patients with symptomatic femoroacetabular impingement indicated 36% of patients had sonographic evidence of inguinal or femoral herniation.

“In our patient cohort, we found roughly 40% of patients with symptomatic FAI[femoroacetabular impingement] had inguinal or femoral herniation,” Thomas H. Wuerz, MD, MSc, of Chicago, said during his presentation at the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress. “Ultrasound of the groin may be a useful adjunct to complete the diagnostic workup of FAI. This might be particularly feasible if you are using ultrasound-guided injections; this would just be a small extra step.”

The study included 78 patients (86 hips) who presented with symptomatic FAI. Patients had an average age of 30 years, and 44% of the patients were women. One of the study authors, who is a board-certified radiologist specializing in ultrasound, performed an ultrasound evaluation of the patients. In addition, patients underwent diagnostic injections.

Thomas H. Wuerz

The investigators found no statistically significant differences for age or other radiologic parameters between patients who had hernias and patients who did not. Overall, there were 66 infiltrations with a 72.7% positive response rate. Wuerz noted 82% of patients with a hernia had a positive response with pain relief, signifying that the hernia was not the source of their groin pain.

Five patients with herniation had no response. Of these patients, one had insertional tendinopathy. Overall, four patients went on to undergo hernia repair, according to Wuerz.

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“In general, there should be a high suspension for abdominal hernias, particularly in patients who do not respond to injections, and there should be a low threshold for obtaining ultrasound,” he said. “If you have any positive findings indicating herniation, the threshold for obtaining a referral to an abdominal surgeon should be fairly low, as well.” – by Gina Brockenbrough, MA

Reference:

Wuerz TH, et al. Paper #152. Presented at: International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress; June 7-11; Lyon, France.

Disclosure: Wuerz has no relevant financial disclosures.