Why is the Groin and Pelvis so difficult to diagnose?

GLSNYTwo weeks ago I was in the lab with one of my colleagues. We were looking at the anatomy of the pelvis on several cadavers. One of the anatomy instructors asked us about the pathology that we see in our practices, and we spent the next 3 hours discussing the multitude of different injuries, syndromes, and aberrations that occur in the groin and pelvis. Finally, the instructor said, “I guess it is just a High Traffic Area.”A high traffic area. This is really an understatement. The pelvis is the home of bone, muscle, nerves, veins, arteries, and sex organs. But nothing, and I mean nothing, runs in a straight line. Every structure in this area tends to go around a bend, weave in or out of a space, tunnel through a hole, or angle around a corner. Furthermore, many of the structures are part of the moving variety, as the pelvis is not only a home for organs, but represents a very large joint in the body. It is no wonder that muscles become tethered, nerves become impinged, and hernias become entrapped.In essence, the biggest and hardest part of our job as specialists in this area, is to make the diagnosis. Often, the actual maneuver to alleviate the problem is the easy part. The diagnosis in a high traffic area, is utterly crucial. 

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