Hip Labral Tear Diagnosis

Early diagnosis of hip labral tear (acetabular labral tear ) represents a clinical importance for patients. This is an underestimated issue in the clinical practice. As an important sign and symptom; the disorder causes hip pain and most of the patient refer to the physicians because of the hip pain. However diagnosing patients with this sign and symptom is relatively new in orthopaedics.

Unfortunately, diagnosing hip labral tear (acetabular labral tear ) is simply disregarded, physical and clinical results are usually confused and clinical studies regarding imaging are generally not specific.

Previously the treatment of hip labral tear has been with open excision (with a high risk of infection) first of the whole labrum, then of only the torn part of the labrum.

Depending on the latest clinical research; arthroscopy has found to be a very effective therapeutic tool in the use of diagnosis and treatment of hip labral tears.

Since 1987, physicians have been exercising arthroscopic treatment of the torn acetabular labrum.

Today physicians should follow up their patient who had hip arthroscopy to ensure their success of the treatment.

Diagnosing young patient population is not very easy and usually very challenging for physicians. The main reason behind this arise, when routine radiographic evaluation fails to reveal a definitive diagnosis.

Please find below the  mechanical symptoms that patients experience (usually young patient population)

• Popping
• Clicking
• Catching

  Opinion leaders in this field clinically observed that although popping, clicking and catching are usually linked to external causes physicians should be suspicious about hip labral tear.

The latest research on hip labral tears regarding the anatomy indicates that the labrum is richly activated through free nerve endings capable of nociception.

The preceding researches were pointing out that acetabular tears come after displacement of the hip. The labrum was reported as a mechanical block to abridgement of the joint.

The clinican Altenbergi was the first person who explained the acetabular labrum tear as a clinical factor that is responsible from hip pain. He reported this statement within1977.
  In his study he presented 2 patients aged 57 and 61. These patients had meaningful relief of pain following the elimination of the torn part of the labrum.

According to the studies of Catteralltl and Dorrell; patients who have dysplasia may have hip labral tears as an independent stimulator of mechanical symptoms and hip pain.

Today arthroscopy is a very common diagnostic and therapeutic tool that is widely accepted.

Depending on the current clinical data it is so far obvious that the presence of arthritis has an impact on the long-term consequence of arthroscopy debridement of the acetabular labrum. As a result; hip pain in adult population should be considered as a serious diagnostic tool even it does not represent a definite diagnosis. Physicians should always question the presence of hip labral tear if the patient apply with the pain history of the hip.

Arthroscopic debridement brings promising clinical outcomes in patiet population who has no radiographic evidence of arthritis. Arthritis patient population seem to have a lower incidence of long-term relief of symptoms.

What is groin pain?

The groin is the joint between the hip and the upper leg.  We observe that part of the patient population describe "groin pain" when they mention testicle pain.

The main causes of groin pain

The following medical conditions are some of the possible causes of Groin pain. There are likely to be other possible causes, so ask your doctor about your symptoms.

• Groin condition
• Groin injury
• Injury of the hip
• Medical status of hip
• Fracture of the pelvis
• Hernia 
• Inguinal hernia 
• Swollen groin lymph nodes 
• Disease of spinal disc 
• Renal stones that leads to radiating pain. 
• Referred pain 
• Orchitis 
• Kidney stone 
• Referred testicular pain 
• Referred scrotum pain 
• Testicular injury

What is the etiology of labral injury? What the risk factors of hip labral tear?

Although in the  majority of the cases are not linked with any specific event or cause, opinion leaders in this field believe that particular sports, movements may be responsible from the development of hip labral tears.

Depending on the clinical trials on hip labral tear (acetabular labral tear ); clinicians have evaluated the patient population with hip labral tear. They have concluded that direct trauma of the tear of the  labrum may have attributed the injury to a variety of causes given below:

• Falling
• slipping (with our without hip dislocation)
• Accidents related with motor vehicle
• Sports that are engaged in frequent lateral rotation
• Hockey
• Soccer
• Ballet
• Golf
• Sprinting
• Running
• Repetitive micro-trauma
• Specific movements
• Hyperextension ( with or without lateral rotation)
• Hyperabduction
• Hyperabduction
• Twisting movements

Today; the clinical assessment of hip labral tears (acetabular labral tears ) including the prevalence and the burden of the disease are not so easy. The main reason behind this is that labral abnormalities are generally considered as part of the natural aging.

Who diagnose hip labral tear?

Orthopaedicians and physciatrists, physical therapy specialists can diagnose hip labral tear (acetabular labral tear ). Sports medicine clinics are experienced in this kind of an indication.

How is hip labral tear diagnosed?

Today people with hip labral tears (acetabular labral tears ) can be easily diagnosed with the employment of proper diagnostic tools. The majority of the patients can be diagnosed simply by taking a adequate patient history, physical exam and MRI.
What the patient will say: I have a terrible hip pain
What the physical examination will eliminate: The other causes of hip pain (other than hip labral tear)
What the x-rays will say: Whether the patient is completely normal or he/she has the sign of femoro-acetabular impingement.
What the pain test will say: Patients will have the most diagnostic information by finding out the source of the pain (whether it is from inside the hip joint).
What the MR Arthrogram will eliminate: the other causes of hip pain including avascular necrosis and tumors.