Hip Labral Tear

Aka: Hip Labral Tear, Acetabular labrum Tear

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II. Pathophysiology

  1. Labrum is fibrocartilaginous tissue surrounding 80% of the superior hip acetabulum

III. Risk Factors

  1. Femoracetabular Impingement
  2. Dance
  3. Gymnastics
  4. Hockey
  5. Basketball
  6. Soccer

IV. Causes

  1. Hip Impingement
  2. Maneuvers with high risk of Hip Labral Tear
    1. Squatting
    2. Jumping
    3. Deep Hip Flexion

V. Symptoms

  1. Anterior Hip Pain
  2. History of hip Trauma or Sports Injury (including repetitive motion)
  3. Catching, clicking, popping or locking Sensation with hip movement

VI. Exam

  1. See Hip Exam
  2. FABER Test
  3. FADIR Test

VII. Imaging

  1. Standing Anteroposterior (AP) Pelvis XRay
    1. First Line Study
  2. MRI Hip
    1. MRI Hip (3 Tesla) without contrast
      1. Adequate Test Sensitivity and Test Specificity to obviate intraarticular gadolinium
      2. Crespo-Rodriguez (2017) Eur J Radiol 88:109-16 [PubMed]
    2. MR Arthrogaphy (1.5 Tesla) with gadolinium intraarticular injection
      1. Lower tesla MRI requires intraarticular gadolinium for adequate sensitivity

VIII. Associated Conditions

  1. Femoracetabular Impingement (esp. young athletes)

IX. Differential Diagnosis

  1. See Hip Pain Causes

X. Management

  1. Physical Therapy
  2. Analgesics
  3. Intraarticular Joint Injection
  4. Surgery in refractory cases (esp. athletes)

XI. References

  1. Schleihauf (2019) Crit Dec Emerg Med 33(5): 19-28
  2. Chamberlain (2021) Am Fam Physician 103(2): 81-9 [PubMed]

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