Groin Pain

Possible Causes of Groin Pain:

From the Implant

  • Aseptic loosening
  • Femoral neck stress fracture
  • Bony impingement
  • Soft tissue impingement
  • Osteonecrosis
  • Reaction to excessive metal wear
  • Metal sensitivity

Referred Pain

  • From the pelvis, back or abdomen

Clinical Tests to Aid Diagnosis:


  • Checks for infection (eg. ESR, CRP)
  • Serum metal ions (if available)
  • (Lymphocyte transformation tests) if available


  • Imaging to assess fixation, implant position, and the presence of fluid build-ups or groin masses

Nuclear medicine

  • Scans to assess infection, fracture or loosening

Adapted from: Metal Sensitivity as a Cause of Groin Pain in Metal-on-Metal Surface Arthroplasties. J. Arthroplasty in press, 2008 P. Campbell, Ph.D A. Shimmin, M.D. 1 L. Walter, M.D. 2 M.Solomon, M.D. 3

Orthopaedic Hospital, UCLA Department of Orthopaedics, Los Angeles CA

  1. Melbourne Orthopaedic Group, Melbourne, Australia
  2. Peninsula Orthopaedics, Sydney, Australia
  3. Prince of Wales Hospital, Sydney, Australia

From: Metal Sensitivity

February 17, 2009