"superior cleft sign" as a marker of rectus abdominus/adductor longus tear in patients with suspected sportsman's hernia

Grainne Murphy, Paul Foran, Darra Murphy, Oliver Tobin, Michael Moynagh, Stephen Eustace

Research output: Contribution to journalArticle

28 Scopus citations


Objective: We describe a new imaging sign, the "superior cleft sign", identified at both symphysography and MRI, which should be used as a marker of rectus abdominis/adductor longus attachment tearing. Materials and methods: A study population of 25 patients presenting with clinically suspected sportsman's hernia, who had undergone both symphysography and MRI of the groin were included for study. In each case, images were reviewed to determine the presence of a superior cleft, secondary cleft, and or both abnormalities. Results: Images of all patients complaining of groin crease discomfort similar to sportsman's hernia revealed the presence of a superior cleft at the rectus abdominis/adductor longus attachment. This "superior cleft sign" correlated with the side of symptoms in each case, and, in contrast to the previously described secondary cleft along the inferior margin of the inferior pubic ramus, occurred parallel to the inferior margin of the superior pubic ramus. Conclusions: The presence of the "superior cleft sign" should be sought in addition to the previously described secondary cleft sign in sportspeople presenting with exercise-related groin pain or pubalgia. It should specifically be sought in patients referred with suspected sportsman's hernia.

Original languageEnglish (US)
Pages (from-to)819-825
Number of pages7
JournalSkeletal Radiology
Issue number6
StatePublished - Jun 1 2013



  • Athletic injuries
  • Magnetic resonance imaging
  • Secondary cleft sign
  • Sportsman's hernia
  • Superior cleft sign

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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