Pain Around Pelvic Area And Groin. X-ray And MRI Clear. What Can Be Done?

Posted on Thu, 23 May 2013

Question: My wife has severe pain in her right side around the pelvic area and towards her groin. She has had an x-ray and an MRI both of which came back clear. Specialist told her this morning she is stuck with it and just needs to manage the pain, however she can barely get out of bed and can't do much anymore. What can she do?

Answered by Dr. Hari Charan Perigela (55 minutes later)

Hi
As per your query,your wife is having severe pain.
As MRI and x XXXXXXX are normal,pain may be due to muscular origin.
Please give her skeletal muscle relaxant and Antioxidant tablets.Add antibiotic too.
Some abdominal conditions like Appendicitis and Right sided ureteric stone can also have pain in the lower abdomen on right side with radiation to the groin and pelvis.
Get an ultrasound abdomen and rule out the above conditions.
If you come back with above tests reports,i will clarify further
Wish her good health
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hari Charan Perigela (40 minutes later)

Hi

Thank you for your reply. I am not happy with it.

1. You are asking me to actually give her antibiotics with neither sign, symptoms nor diagnosis of bacterial infection. This is very irresponsible. A wild guess?
2. You are recommending muscle relaxants for which there is little or no proper evidence to support their effectiveness.
3. You are asking me to give her antioxidants without telling me why, or for what. Another wild guess?
4. I have told you that she had an MRI which was clear and yet you are suggesting Appendicitis.

I would like a refund please, this advice is poor and not in the least helpful.

Answered by Dr. Hari Charan Perigela (2 hours later)

Hi
As per your first query,you told that she is having pain and her investigations are normal.
So,bony causes are excluded.
You didnot mention the area/part of which MRI was taken.I thought MRI was taken for pelvis.
1.I have seen many cases of appendicitis wi
th pelvic pain.The location of appendix will not be the same in all individuals.There is an entity called pelvic appendicitis.So,i prescribed antibiotic for suspected appendicitis.
2.If the patient is having pain near bony parts and xray and MRI are normal,then muscular pain has to be considered
3.Antioxidants will relieve pain in some individuals.
4.You have not mentioned that MRI of abdomen was taken.But,when pelvic pain is complained the radiologist might have missed intra abdominal disease.But,CT Scan is superior for appendicitis.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hari Charan Perigela (4 hours later)

She had an ultrasound last year because kidney stones were suspected and that was clear. She was told after her scan that her appendix was normal. She is currently on pain relief so I can't see the point in antioxidants unless they are treating something specific. Is intra-abdominal disease the same thing as appendicitis?

Answered by Dr. Hari Charan Perigela (11 hours later)

Hi
Ultrasound can diagnose kidney stones.
In case of appendicitis,unless appendix is grossly inflammed and enlarged it is not seen in ultrasound.
Faecal stones called faecoliths can be present in the appendix and cause pain in apoendicitis.
These things are clearly seen by CT scan.
Appendix is intra abdominal organ.if it is inflammed or blocked with stones,there will be pain.
Please exclude this and slso femoral/inguinal hernia
Here,if the patient is having pain in the lower part of abdomen on right side and all the tests come normal, we do Appendicectomy
Wish her good health
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar