Core Muscle Injury: A Combined Orthopaedic and General Surgery Algorithmic Approach for Diagnosis, Imaging, and Treatment
Ariana Lott, Caroline A. Dannacher, Mohammad M. Samim, Mary Ann Hopkins, Jordan Taylor, Spencer Stein, Xavier Pereira, Natasha Desai, Abigail Campbell
» 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.