Conclusion

Undiagnosed Groin, Abdominal, and Pelvic (UGAP) pain is not an uncommon condition and millions of patients, both females and males suffer from it. It is a great masquerader mimicking several different lower abdominal, groin and pelvic conditions.
Let’s all think of UGAP pain in patients presenting with atypical pain over the lower abdomen, groin, and pelvis. This is one of the few enigmatic conditions where a diagnosis can be strongly suspected in the majority of the patients just on clinical examination.

Let’s help these “Silent Sufferers” and prevent them from doctor shopping, minimize expensive diagnostic workup and prevent unnecessary endoscopies and even unnecessary surgeries. In the process, we will be saving billions of dollars which are currently spent in diagnosing and treating these unfortunate patients.

In our series we have placed emphasis on myofascial origin in nearly 90% of our patients.. I believe periosteitis, in addition to enthesopathy plays an important part in the etiology of this syndrome. This is unique but relatively straightforward condition affecting nearly millions of patients. On physical examination of the abdomen thorough examination of the surrounding bony points even during pelvic and rectal and also using seven signs described helps in suspecting diagnosis of UGAP pain. Confirmation of the diagnosis as well as treatment objectives is achieved simultaneously with strategically placed steroid injections. Literally billions of dollars are saved by making swift diagnosis and administering appropriate conservative treatment. Also pain and suffering along with the cost of loss of productivity in minimized. I feel we are still in the learning phase about this an enigmatic condition and much research, needs to be done to streamline our approach and minimize or eliminate unnecessary investigations, invasive procedures, and sometimes unnecessary operations.