CT引导下经皮穿刺活检术在骨骼病变诊断中的应用

目的探讨CT导引下肝细胞生长因子(HGF)基因治疗脑缺血的可行性。方法采用基因重组技术构建携带HGF基因的真核表达质粒,通过脂质体介导法,在CT灌注扫描图像定位下将其多点注射到大鼠急性脑梗死模型的缺血半暗带区域;转染7 d后断颈取脑,切片观察HGF基因于大鼠脑内的表达情况及其生物学效应。结果酶切鉴定及基因测序证实,HGF基因片段已克隆到PIRES2-EGFP的BamH I和Sal I位点之间。HGF基因转染大鼠缺血半暗带区7 d后免疫组化方法证实实验组大鼠转染局部已有HGF表达,血管数量明显多于对照组(P<0.01);CT灌注显示其梗死侧半球的脑血流量高于对照组(P<0.01);TTC染色显示实验组大鼠脑梗死体积小于对照组(P<0.01)。结论脂质体转染HGF基因能够在缺血半暗带区表达,其表达产物能够发挥生物学效应并促进局部侧支循环形成,从而改善脑缺血。     

125I-抑制素在大鼠垂体和下丘脑的放射自显影研究

目的研究抑制素（INH）在体条件下能否通过大鼠的血脑屏障及在垂体或下丘脑的分布。方法采用颈静脉灌流和放射自显影技术，将20只SD大鼠分为4组，每组5只，第1～3组（实验组）颈静脉注射^125 I-INH50μl，第4（对照）组注射等量的生理盐水。第1，2，3组分别于注射后30，60和120min断头处死，取出垂体、下丘脑，以生理盐水洗涤，测量放射性计数，取放射性最大组的垂体与下丘脑组织行放射自显影分析。结果第1组垂体的放射性最高[（1008．00±5．78）Bq]，而第2和3组分别为（723．00±4．95）和（491．00±4．90）Bq；1～3组的下丘脑放射性分别为（20．00±1．01），（22．00±0．95）与（19．00±0．73）Bq。第4组垂体与下丘脑的放射性分别为（16．00±1．40），（15．00±0．98）Bq。各实验组大鼠垂体的放射性与对照组差异有统计学意义（P〈0．01），且在注射后30min放射性最大（第1组），60和120min后逐渐降低；而实验组与对照组大鼠的下丘脑放射性差异无统计学意义（P〉0．05）；放射自显影结果示，实验组大鼠的垂体组织上有明显的银颗粒，而对照组没有；实验组和对照组大鼠的下丘脑组织上均未见明显的银颗粒。结论^125I-INH能通过大鼠血脑屏障，垂体在注射后30min放射性最大，在大鼠垂体上有INH结合位点或受体，而在其下丘脑没有。     

注射速率对孤立性肺结节64层螺旋CT灌注成像影响的初步研究

目的：利用64层螺旋CT探讨孤立性肺结节CT灌注成像技术中对比剂注射速率对结果的影响。方法：对50例孤立性肺结节患者进行前瞻性研究。随机将患者分为两组，注射速率分别为3ml／s（组1）及5ml／s（组2）；男性34例，女性16例。年龄范围28～73岁，平均年龄56．02&#177;9．11岁。其中，43例通过手术证实；2例通过CT引导经皮肺穿刺活检证实；1例通过纤支镜活检证实；4例同时发现全身多处转移性肿瘤。结果：组1中，血流量值：49．006&#177;42．429ml&#183;100g^-1&#183;min^-1、血容量：3．358&#177;4．608ml／100g，平均通过时间：6．307&#177;3．772s，表面渗透性：9．378&#177;9．040ml&#183;100g^-1&#183;min^-1。组2：血流量：52．917&#177;61．206ml&#183;100g^-1&#183;min^-1，血容量：3．045&#177;4．671ml／100g，平均通过时间：6．079&#177;3．831s，表面渗透性：8．142&#177;7．082ml&#183;100g^-1&#183;min^-1。组1与组2结节血流量（P=0．249〉0．05）；血容量（P=0．737〉0．05）；平均通过时间（P=0．776〉0．05）；表面渗透性（P=0．454〉0．05）。不同注射速率的两组孤立性肺结节灌注值统计学差异无统计学意义（P〉0．05）。结论：不同的对比剂注射速率（3ml／s和5ml／s）对64层螺旋CT孤立性肺结节灌注成像无明显影响。     

血红素加氧酶-1基因转染对大鼠心肌缺血再灌注损伤的保护作用

目的：观察腺病毒介导的血红素加氧酶-1基因（rHO-1）转染后,HO-1在大鼠心肌的表达及其对缺血再灌注损伤心肌的保护作用。方法：雄性SD大鼠随机分为4组：假手术对照组（SH）、生理盐水组（NS）、空载体组（Ad）和Ad-HO-1转染组（HO）,各组12只。后3组分别于心尖部分别注射1ml生理盐水、含空载体腺病毒（5．0&#215;10^9PFU）和重组HO-1腺病毒50μl（7．5&#215;10^9PFU）。在基因转染3d后,采用左冠状动脉前降支结扎开放建立心肌缺血再灌注模型。每组大鼠测定心功能后取心腔内血,做心肌酶检测,处死大鼠并取左心室标本,测定左心室心肌梗死面积,于荧光显微镜下观察心肌组织荧光蛋白的表达情况,RT—PCR、Westernblot检测心肌组织HO-1mRNA、蛋白的表达。结果：HO组中HO-1表达量明显高于Ad组和NS组,Ad和HO组左室心肌均见有荧光蛋白表达,其转染率为（55．5&#177;3．5）％。各时相点HO组的SBP、DBP、MAP、＋dp／dtmax和-dp／dtmax等指标恢复率均显著高于Ad组和NS组（P〈0．01）。与SH组比较,NS组、Ad组血清LDH和CK—MB水平、梗死心肌重量、心肌梗死面积升高（P〈0．01）。与NS组或Ad组比较,HO组血清LDH和CK-MB水平、梗死心肌重量、心肌梗死面积减少（P〈0．01）。结论：腺病毒携带的HO-1基因能有效的转染心肌组织,并在体内稳定表达;HO-1基因转染对缺血再灌注的心肌有明显的保护作用。     

心肌显像联合冠状动脉造影及组织学检查在评价Ad-HGF治疗猪心肌梗死疗效中的价值

目的探讨心肌静息显像联合冠状动脉造影及组织学检查在评价重组腺病毒-肝细胞生长因子（Ad—HGF）治疗猪实验性心肌梗死中的价值。方法低、中、高剂量Ad—HGF治疗组[Ad-HGF剂量依次为10^8，4×10^8，5×10^9空斑形成单位（PFU）／点；均分10点注射]，生理盐水对照组及空白对照组小型猪各5头，分别于治疗前后行静息心肌显像及冠状动脉造影，并于治疗后行组织学检查。结果空白对照组及生理盐水对照组治疗前后心肌灌注及Rentrop评分无明显变化。各Ad-HGF治疗组治疗后心肌灌注及Rentrop评分较治疗前改善，低、中、高剂量组治疗前后冠状动脉左回旋支（LCX）供血节段得分分别为7．8±1．3和16．4±1．1（低），8．2±1．6和17．6±0．9（中），8．4±1．5和19．0±0．7（高）；各组治疗前后LCX供血区域Rentrop评分分别为0．80±0．16和1．66±0．15（低），0．94±0．11和2．16±0．11]（中），0．90±0．22和2．22±0．19（高）。3组治疗前后数据比较差异均有统计学意义（P〈0．01）。各Ad-HGF治疗组及空白对照组治疗后血管数量明显多于生理盐水对照组。结论用心肌静息显像联合冠状动脉造影及组织学检查评价Ad-HGF治疗猪心肌梗死的疗效有价值。     

MRI评价亚急性硬化性脑脊髓病患儿的脑灌注特点

目的探讨亚急性硬化性脑脊髓病患儿的脑血流灌注特点。方法对12例亚急性硬化性脑脊髓病患儿和无代谢性脑病或脑血管性疾病的13例对照组患儿进行了流速敏感交替反转恢复免除独立T1测量序列扫描，通过后处理生成脑血流量图，分别测量双侧基底节区和丘脑的相对脑血流量比值（rCBF），进行统计学比较，并对双侧基底节区的rCBF进行受试者工作曲线（ROC）分析。结果亚急性硬化性脑脊髓病组和对照组的右侧基底节区的rCBF分别为0．432±0．158和0．619±0．125，左侧基底节区的rCBF分别为0．478±0．186和0．621±0．123，右侧丘脑的rCBF分别为0．630±0．189和0．833±0．160，差异具有统计学意义（分别为t=3．26，P=0．002；t=2．25，P=0．018；t=2．88，P=0．004）。右侧和左侧基底节区rCBF的受试者工作曲线下面积分别为0．833和0．756。结论MR灌注成像能够显示亚急性硬化性脑脊髓病患儿的脑血流改变，提示患儿双侧基底节区脑灌注的异常，为临床提供新的参考信息。     

肝功能衰竭大鼠脑水通道蛋白-4表达与MR扩散加权成像的相关性研究

目的研究水通道蛋白-4（AQP-4）在急、慢性肝功能衰竭时脑组织中的表达规律，应用MR扩散加权成像（DWI）探讨脑水肿的分子生物学机制。方法雄性SD大鼠65只采用数字表法随机分为急性组（25只）、慢性组（25只）和对照组（15只），分别诱发急、慢性肝功能衰竭。行DWI观察异常信号分布情况，测量顶部皮质区、外侧部皮质区和邻近侧脑室区的DWI信号强度。处死后进行血氨检测，取与DWI检查对应的大脑层面切片行病理观察、免疫组织化学及逆转录．聚合酶链式反应（RT—PCR）检测，检测AQP-4蛋白表达水平，并进行统计学分析。结果急性组肝细胞坏死及脑水肿明显，慢性组呈肝硬化改变，脑水肿不明显。血氨浓度急性组、慢性组和对照组分别为（516±46）、（158±26）和（148±32）μmol／L，差异有统计学意义（F=188．325，P〈0．01）。顶部皮质区、外侧部皮质区和邻近侧脑室区的DWI信号强度对照组分别为516±160、727±183和656±181；急性组分别为1766±438、1223±503和1216±446；慢性组分别为700±213、820±263和713±243，差异均有统计学意义（F值分别为44．612、3．422和5．581，P值均〈0．05）。相应区域AQP-4蛋白表达水平（用平均灰度值表示）对照组分别为7379±1617、8104±2093和4851±2178；急性组分别为9580±2616、11057±2334和2949±1735；慢性组分别为12137±2332、11135±3102和7688±2925，3组间差异均有统计学意义（F值分别为11．414、4．602和7．002，P值均〈0．05）。急性组AQP-4蛋白表达水平与DWI信号强度有相关性（r=0．756，P〈0．05），慢性组AQP-4蛋白表达水平与DWI信号强度无相关关系（r=0．236，P〉0．05）。结论在急、慢性肝功能衰竭中血氨增高是导致脑内能量代谢异常、星形胶质细胞内AQP-4mRNA和蛋白表达增加的主要因素；DWI技术发现的信号异常可很好的反映脑水肿、AQP-4蛋白表达异常的范围、程度。     

鼻咽癌CT灌注成像及其生物学相关性研究

目的研究鼻咽癌CT灌注值与肿瘤微血管密度（MVD）、肿瘤分期的关系，探讨多层螺旋CT灌注成像对鼻咽癌的临床应用价值。方法49例鼻咽部CT灌注检查中，鼻咽癌组30例，鼻咽癌放疗后组14例，正常鼻咽部5例，测量鼻咽癌和鼻咽黏膜位置的血流量（BF）、最大强化指数（PEI）、峰值到达时间（TTP）及血容量（BV）作为灌注指标，其中16例鼻咽癌活检组织行免疫组织化学CD34单抗染色后，Weidner方法计数MVD。各组灌注值比较行方差分析，CT灌注值、肿瘤分期与MVD之间行Spearman等级相关分析。结果49例中1例鼻咽癌灌注检查失败。鼻咽癌组（29例）肿瘤CT灌注值BF为（48．6±16．9）ml·100g^-1·min^-1，PEI为（32．3±7．9）HU，TTP为（17．5±4．9）s，BV为（12．8±4．4）ml·100g^-1；正常对照组（5例）BF、PEI、TTP、BV值分别为（15．9±5．9）ml·100g^-1·min^-1、（12.6±1．3）HU、（22．6±6．9）s、（3．5±0．5）ml·100g^-1；鼻咽癌放疗后组（14例）BF、PEI、TTP、BV值分别为（25．2±7．0）ml·100g^-1·min^-1、（19．8±5．9）HU、（22．6±4．3）s、（6．1±2．4）ml·100g^-1，三组各灌注值差异有统计学意义（P值均〈0．01）；相关分析显示，鼻咽癌组（29例）中TNM分期（其中Ⅰ期3例，Ⅱ期9例，Ⅲ期10例，Ⅳ期7例）与PEI和BV存在相关性（r值分别为0．48和0．50），与BF和TTP无明显相关性（r值分别为0．23和0．22）；16例鼻咽癌MVD为（30．8±12．6）个／高倍镜视野，与其BF（51．4±17．0）ml·100g^-1·min^-1、PEI（33．2±9．6）HU和TTP（16．3±4．1）8存在相关性（r值分别为0．85、0．60和0．78），与BV（13．2±5．6）ml·100g^-1弱相关（r=0．48）。结论鼻咽癌有着特征的CT灌注表现，多层螺旋CT灌注成像的灌注值可以反映鼻咽癌微血管密度特征，PEI和BV值与鼻咽癌的TNM分期存在一定的相关性。     

乳腺病变动态增强MRI与血管生成的相关性

目的探讨乳腺良、恶性病变MR动态增强（DCE）参数与肿瘤血管生成的关系。方法对51例乳腺良、恶性病变患者行前瞻性DCE—MR检查，计算动态增强参数：最大增强线性斜率（Smax，增强峰值（PH）、峰值时间（Tpeak）。所有病例手术病理标本行免疫组织化学染色，测定微血管密度（MVD）计数和血管内皮生长因子（VEGF）表达，分析各动态增强参数与乳腺癌MVD和VEGF表达的相关性。并比较29例乳腺癌与12例乳腺纤维腺瘤、10例乳腺病、10例癌旁正常组织MVD计数和VEGF表达的差别。结果乳腺癌Smax（2．04±1．8；r=0．807，P〈0．01）、PH（678±260；r=0．697，P〈0．01）与MVD呈正相关，Tpeak（69±38）与MVD呈负相关（r=-0．425，P〈0．05）。乳腺癌组MVD计数[（65．09±15．81）个／200倍视野]明显高于纤维腺瘤组、乳腺腺病组及癌旁正常组织组（P值分别为0．043、0．018、0．002）。69％（20／29）乳腺癌VEGF表达阳性，也明显高于其余各组（P值分别为0．035、0．007、0．001）。乳腺癌边缘区域的MVD（60．38±24．14）个／200倍视野，高于中央区域（37．64±16．52）个／200倍视野；（t=2．635，P=0．016）。腋窝淋巴结转移组的MVD（73．23±23．02）个／200倍视野，高于无转移组（59．34±18．03）个／200倍视野，（t=2．303，P=0．031）。结论乳腺癌部分MR—DCE参数与MVD、VEGF相关，能较客观地反映乳腺癌血管生成状况，其MVD计数和VEGF表达明显高于乳腺良性病变及癌旁正常组织。     

锌指蛋白A20及其突变体质粒转染对小鼠内毒素血症的预防作用

目的 研究锌指蛋白A20（mA20）及其突变体mA20-ZnF4-7质粒转染对脂多糖（LPS）攻击所致小鼠内毒素血症的预防作用。方法用LPS攻击小白鼠制备内毒素血症动物模型。随机分为等渗盐水对照组（Ns组）、单纯LPS组（LPS组）、pCAGGS-flag组（质粒组）、pCAGGS-flag-mA20预防组（mA20组）和pCAGGS-flag-mA20-ZnF4-7预防组（mA20突变体组）。按10μg质粒：1．6ml等渗盐水比例溶于等渗盐水中，采用“基于流体动力学基因转染方法”对实验小鼠进行质粒预防性注射。以ELISA检测各组血浆和组织TNF-α、IL-1β表达并观察组织病理变化。结果 （1）mA20组和mA20-突变体组的TNF-α在各时相点表达分别为：6h：（211．942±9．133）pg／ml、（163．536±0．502）pg／ml，12h：（195．130±26．318）pg／ml、（206．446±34．797）pg／ml，24h：（182．963±14．527）pg／ml、（158．029±19．176）pg／ml，均显著低于LPS组和质粒组（P〈0．05）。（2）mA20组和mA20突变体组的IL-1β在各时间点表达分别为：6h：（137．908±4．487）Pg／ml、（138．598±8．733）pg／ml，12h：（137．678±3．539）pg／ml、（137．448±7．953）pg／ml，24h：（129．862±11．602）pg／ml、（126．873±6．942）pg／ml，均显著低于LPS组和质粒组（P〈0．05）。（3）mA20组和mA20突变体组内各时间点之间TNF-α及IL-1β表达比较，差异无统计学意义（P〉0．05）。（4）病理观察结果显示，mA20组和mA20突变体组的肝、肺损伤均较LPS组和质粒组轻。结论 基于流体动调控炎症反应力学的mA20及其突变体mA20-ZnF4-7质粒转染对实验性内毒素血症有相似的预防作用，mA20有功能丰余性，为临床应用及mA20突变体研究提供了一定的实验基础。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.