Diagnostic Criteria for Left Adductor Magnus Enthesopathy Injection

Clinical Evaluation and Diagnostic Workup

A complete pelvic and perineal examination with specific palpation of the adductor magnus origin at the ischiopubic ramus is required to identify localized tenderness, as recommended by the American College of Radiology 1, 2
Digital rectal examination is necessary to exclude occult pathology, including masses or abscesses, according to the American College of Radiology 1
Musculoskeletal examination focusing on the adductor enthesis and pubic symphysis region is mandatory, as suggested by the American College of Radiology 2

Transvaginal and transabdominal ultrasound with Doppler is the initial imaging modality of choice for evaluating pelvic and perineal pain, as recommended by the American College of Radiology 1, 2
MRI pelvis with gadolinium contrast serves as the problem-solving examination when ultrasound is nondiagnostic or inconclusive, and can visualize adductor enthesopathy, according to the Journal of the American College of Radiology 3, 2

Pelvic venous disorders, such as pelvic congestion syndrome, must be excluded through imaging studies, as recommended by the Journal of the American College of Radiology 3, 4
Alternative diagnoses, including anorectal abscess, Fournier's gangrene, and chronic pelvic inflammatory disease, must be excluded through appropriate imaging and diagnostic workup, according to the American College of Radiology 1, 3
The diagnosis code must be specific, such as M76.82 (enthesopathy of lower limb) or M25.552 (pain in left hip), once adductor enthesopathy is confirmed, as suggested by the American College of Radiology 1, 2