However, the modality would be able to depict the anatomy and, theoretically, visualize a hernia. The specific performance attributes are unknown. MRI Pelvis MRI is useful and can help visualize anatomic structures. In a retrospective review of 36 patients with suspected occult inguinal hernia, MRI demonstrated a sensitivity, a specificity, a PPV, and an NPV of 91%, 92%, 95%, and 85%, respectively, correctly diagnosing hernia in 10 of 11 patients [32]. In a retrospective review of 117 athletes who underwent MRI for groin pain, inguinal hernia was diagnosed in 35% of patients [26]. There are no specific data differentiating diagnostic efficacy of IV contrast versus noncontrast examination. Radiography Abdomen and Pelvis In case series of 170 and 204 herniographies for diagnosis of occult groin hernia, 49% and 35% were positive, respectively [34,35]. However, in the Ward et al study [35], 6 of 41 patients undergoing surgical repair, 16% were found to not have a hernia in the series. Whereas, in the Hachem et al study [34], all 84 patients with positive herniogram had hernia confirmed at surgery. In a third series of patients suspected of having occult inguinal hernia, herniography was found to have a sensitivity and specificity of 91% and 83%, respectively [31]. US Pelvis Diagnostic performance of US is common in the diagnosis of occult inguinal hernia. In a retrospect analysis of 297 patients, 116 went on to surgery. Based on surgical findings, US had a sensitivity of 94% with a PPV of 73% [36]. When US was performed by musculoskeletal experts, US had a sensitivity of 96.3% [37]. Hernia examination yielded a sensitivity and specificity of 96% [42]. In a case series of 18 consecutive pregnant patients with groin pain and swelling with clinical suspicion of hernia, hernia was not present in any patient and symptoms resolved following delivery [43]. Color Doppler US was positive for enlarged veins around the round ligament. Variant 3: Suspected deep pelvic hernia including obturator, sciatic, or perineal.
Hernia. However, the modality would be able to depict the anatomy and, theoretically, visualize a hernia. The specific performance attributes are unknown. MRI Pelvis MRI is useful and can help visualize anatomic structures. In a retrospective review of 36 patients with suspected occult inguinal hernia, MRI demonstrated a sensitivity, a specificity, a PPV, and an NPV of 91%, 92%, 95%, and 85%, respectively, correctly diagnosing hernia in 10 of 11 patients [32]. In a retrospective review of 117 athletes who underwent MRI for groin pain, inguinal hernia was diagnosed in 35% of patients [26]. There are no specific data differentiating diagnostic efficacy of IV contrast versus noncontrast examination. Radiography Abdomen and Pelvis In case series of 170 and 204 herniographies for diagnosis of occult groin hernia, 49% and 35% were positive, respectively [34,35]. However, in the Ward et al study [35], 6 of 41 patients undergoing surgical repair, 16% were found to not have a hernia in the series. Whereas, in the Hachem et al study [34], all 84 patients with positive herniogram had hernia confirmed at surgery. In a third series of patients suspected of having occult inguinal hernia, herniography was found to have a sensitivity and specificity of 91% and 83%, respectively [31]. US Pelvis Diagnostic performance of US is common in the diagnosis of occult inguinal hernia. In a retrospect analysis of 297 patients, 116 went on to surgery. Based on surgical findings, US had a sensitivity of 94% with a PPV of 73% [36]. When US was performed by musculoskeletal experts, US had a sensitivity of 96.3% [37]. Hernia examination yielded a sensitivity and specificity of 96% [42]. In a case series of 18 consecutive pregnant patients with groin pain and swelling with clinical suspicion of hernia, hernia was not present in any patient and symptoms resolved following delivery [43]. Color Doppler US was positive for enlarged veins around the round ligament. Variant 3: Suspected deep pelvic hernia including obturator, sciatic, or perineal.