If the data could not be pooled, a synthesis of the “levels of evidence” was performed. There has been strong evidence that athletes with hip and groin pain: lower patient-reported scores (PRO) and a change in body function compared to controls. Moderate evidence has been established that bone marrow edema and secondary signs of fission are associated with hip and groin pain in athletes compared to asymptomatic controls. While studies of risk factors should ideally be prospective in design, cross-sectional and case control studies allow several factors to be studied in smaller populations. Although no cause-effect relationship can be established, these factors can be considered in future studies of risk factors, studies and treatments. .