MRI case in groin pain syndrome: do not neglect to consider the sinuvertebral nerve (Luschka’s nerve)

Abstract Background Groin pain can be the result of a many pathophysiological pathways; however, not all groin pains are related to the most common musculoskeletal causes. Magnetic resonance imaging is the best diagnostic imaging tool. Main body of the abstract We report a case of a young man with lumbar disk herniation at L4–L5 level presenting an unusual groin pain that could not be explained by the sensory distribution depending on the involved dermatome. The sinuvertebral nerve, alias Luschka’s nerve, innervates the posterior part of the intervertebral disk and the surrounding structures. When it is stimulated, for example by a lumbar hernia, the sensory input through the sympathetic trunk is processed as a somatic pathway, resulting in a referred pain in the groin area. We performed a literature review, depicting anatomy, pathophysiology, and therapeutic options of this connection pathway, which should not be forgotten in the assessment of groin pain, as it can explain the symptoms and can benefit from specific treatments. Short conclusion This case demonstrates how the sinuvertebral nerve is linked to the creation of discogenic groin pain and how paravertebral ozone injections are a reliable and efficient therapy for patients with LDH.