Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What can cause groin pain radiating to the knee?
Can a bad hip joint cause groin pain?
How is osteoarthritis diagnosed?
What are the symptoms of sciatica?
How can I tell if I have an inguinal hernia?
What treatments are available for osteoarthritis?
How can I relieve sciatica pain at home?
Does a decreased urinary stream indicate a serious problem?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Hello, it’s good to meet you. I understand you’re having pain in your right groin area. Is that correct?
Patient
Yes, that's right.
Cody, the AI Doctor
My goal is to provide you with an accurate assessment and plan. Can you describe when and how your groin pain started?
Patient
It started gradually about three months ago.
Cody, the AI Doctor
I see. The duration helps give us clues. Does the pain stay in one spot, or does it radiate elsewhere?
Patient
It starts at my groin but then radiates to my right testis and sometimes down to my right knee.
Cody, the AI Doctor
Thank you for sharing that detail. How would you describe the pain on a scale of 1 to 10, with 10 being the most severe?
Patient
When it’s bad, it's about a 6 out of 10.
Cody, the AI Doctor
Understood, that’s quite significant. Do you notice if the pain gets worse with certain activities?
Patient
Yes, it's worse when I walk or when I get up and down.
Cody, the AI Doctor
That's very useful to know. Have you noticed any changes in your urination, such as blood in the urine or trouble urinating?
Patient
No blood, but I've had a chronically decreased stream for some time and get up once a night to urinate.
Cody, the AI Doctor
It’s important to rule out any potential urinary tract issues. Do you have any fever or chills associated with the pain?
Patient
No, none at all.
Cody, the AI Doctor
Fever and chills can sometimes indicate an infection, so it’s good you don’t have those symptoms. Is the pain constant, or does it come and go?
Patient
It comes and goes.
Cody, the AI Doctor
Does taking over-the-counter pain medications, like Tylenol, help with the pain at all?
Patient
It provides only mild improvement in my symptoms.
Cody, the AI Doctor
Thank you for providing all this information. I’m compiling all the details to help narrow down what might be causing your pain. You mentioned you have high blood pressure and you're overweight. Can you tell me your height and weight for context?
Patient
I’m 5'10" and weigh about 240 pounds.
Cody, the AI Doctor
Understood. I’m about ready to share my top three potential diagnoses, but before I do that, is there anything else you think is important for me to know?
Patient
No, I think I’ve told you everything.
Cody's AI Summary
- You are a 57-year-old man with groin pain.
- You have developed pain in your right groin gradually over the past three months.
- It worsens when you walk and when getting up and down, and over-the-counter pain medications like Tylenol provide only mild improvement.
- The pain radiates to your right testis and sometimes down your right knee.
- The pain is intermittent and reaches a level of 6 out of 10 in severity.
- You have no fever, chills, or blood in your urine.
- You have high blood pressure and you describe yourself as overweight.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Osteoarthritis(50 % probability)
Osteoarthritis is a degenerative joint disease that can cause pain and stiffness, especially in weight-bearing joints like the hip, which can present as groin pain and may radiate down the leg.
2. Sciatica(30 % probability)
Sciatica involves the irritation of the sciatic nerve, often causing pain that radiates from the lower back down to the legs and can mimic groin pain.
3. Inguinal Hernia(20 % probability)
An inguinal hernia occurs when a part of the intestine protrudes through a weak spot in the abdominal muscles, causing groin pain and potentially affecting structures like the testis. Further diagnostic steps, such as imaging and physical examination, would be beneficial for pinpointing the exact cause of your pain.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
In reviewing the patient’s history and symptoms of progressive right groin pain that radiates to the testis and knee, coupled with the intermittent nature of the pain, provides significant insight into potential diagnoses. This presentation of worsening pain with movement and being overweight, narrows down the differential diagnosis. These diagnoses are frequently down-played or missed with people coming to the doctor with groin pain.
1. Osteoarthritis of the hip(70% probability)
is highly probable given the patient's age, weight, and pain character, especially since it worsens with movement. This condition commonly affects weight-bearing joints, causing referred pain that can radiate down the limb.
2. Sciatica(20% probability)
could also be a consideration due to the pain radiating down the leg, indicative of nerve involvement. However, the absence of lower back pain in the patient's account makes this a less likely primary cause.
3. Inguinal Hernia(10% probability)
could be the cause of groin and testicular pain, particularly if there's an associated bulge or strain exacerbating the condition. It is worth investigating further through a detailed physical exam and imaging to rule out this possibility.
Next Steps for Evaluation
Physical Examination: The first step should be a detailed physical examination of the back, hips, groin, testicles and knee to check for palpable abnormalities, particularly for signs of limited hip range of motion, pain or clicking with rotation of the hip, and check the groin for signs of an inguinal hernia.
Imaging Studies: X-ray or MRI of the hip to evaluate for osteoarthritis, and possibly an ultrasound if hernia or other testicular pathology is suspected.
Potential Treatment Modalities
Here is a list of treatment modalities for osteoarthritis of the hip, arranged from least to most invasive:
Lifestyle Modifications
Weight management
Low-impact exercise (e.g., swimming, walking)
Physical therapy
Medications
Acetaminophen (Tylenol)
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Topical pain relievers
Assistive Devices
Canes or crutches
Joint supports or braces
Alternative Therapies
Acupuncture
Yoga or tai chi
Joint Injections
Corticosteroid injections
Hyaluronic acid injections
Platelet-rich plasma (PRP) injections
Minimally Invasive Procedures
Arthroscopy (less commonly used for osteoarthritis)
Surgical Options
Osteotomy
Hip resurfacing
Total hip replacement (arthroplasty)
Resource Center
Testimonials
The questions Cody asks are quite professional and easy to comprehend. His responses are also great. I am truly amazed that I can consult with Cody in such relaxed atmosphere.
TrustPilot Review
Attentive and asked questions. I really felt like all my symptoms were taken into account and evaluated without being dismissed.
TrustPilot Review
Easily confirmed what I suspected. Very thorough, definitely the best thing you can get without speaking to a human.
TrustPilot Review
