Core Muscle Injury: A Combined Orthopaedic and General Surgery Algorithmic Approach for Diagnosis, Imaging, and Treatment.

Abstract

» Core muscle injury (CMI) is a common cause of groin pain in athletes and reflects pathology of the inguinal canal, rectus abdominis-adductor longus (RA-AL) aponeurosis, and pubic symphysis. » There is a substantial lack of consensus on terminology and diagnostic criteria for CMI, hindering standardized evaluation, management, and research initiatives. » Diagnosis relies on structured history, physical examinations, and provocative maneuvers to identify CMI and concurrent pathology, and fluid-sensitive pelvic magnetic resonance imaging to characterize RA-AL injury. » Treatment strategies differ across sports medicine physicians, general surgeons, and orthopaedic surgeons, underscoring the need for early cross-departmental referrals to ensure all contributing pathologies are comprehensively identified and addressed. » When both adductor/RA-AL aponeurosis and inguinal canal/abdominal wall pathologies are present, prioritizing collaborative cases between orthopaedic and general surgeons is essential for decreasing operating room time, streamlining rehabilitation, and optimizing return-to-sport outcomes.