This patient is a 64 year old male with a PMH of depression, anxiety, COPD, gastritis, and previous right inguinal hernia repair who presented to the emergency room with one day of right groin pain that occurred suddenly the night before. He has never experienced pain like this before and over the counter analgesics did not relieve the pain. Patient states that the pain is associated with a small budge in the right groin that is tender to palpation . On physical exam patient had a soft and non-tender abdomen. An exquisitely tender 2cm x 2cm palpable nodule in the right groin was noted.