Hip Labral Tear

What is a Labral Tear?

A labral tear is a tear in the tissues surrounding the hip joint called the labrum. The labrum is a tough, cartilaginous structure that lines the inside of the hip socket. There are two pairs of labrums in the body: one in the shoulder and one in the hip. The labrum provides much needed stability and cushioning during lower body movements. Understanding that the labrum is vital to hip motion is essential for understanding the symptoms and treatment options for labral tears.

What are the causes of Labral Tears?

Labral tears can be caused by various factors including trauma or underlying changes in bony anatomy. In older patients, repetitive motions over time can cause wear and tear that can cause tears. In athletes, labral tears are common in runners, hockey players, soccer players, and football players after certain sudden impacts. Changes in bony anatomy including hip impingement (see FAIS) or osteoarthritis can also lead to bone-on-bone contact that wears down the labrum.

What are the symptoms of Labral Tears?

Common symptoms of labral tears include:

1. Deep groin pain or pain in the buttocks or side of the hip
2. A feeling of clicking or locking when moving the hip
3. Hip stiffness
4. Pain that worsens with periods of long standing, sitting, or physical exercise
5. Limited range of motion with certain movements of the hip

How are Labral Tears Diagnosed?

Dr. Shane J. Nho diagnoses labral tears through a comprehensive evaluation, including a combination of medical history assessment, physical examination, imaging studies, and diagnostic injections. Proper diagnosis is crucial for determining the underlying cause of hip pain and guiding appropriate treatment strategies to alleviate symptoms and improve joint function. Diagnostic tools may include:

Medical History Assessment

Reviewing the patient’s history for hip pain, previous injuries, or activities that exacerbate symptoms. Dr. Shane J. Nho will inquire about any previous hip injuries, surgeries, or medical conditions that may contribute to hip pain. Additionally, information about the onset and duration of symptoms, as well as any aggravating or alleviating factors, can provide valuable insights into the condition’s nature and severity.

Physical Examination

A comprehensive physical examination is essential for assessing hip joint impingement, range of motion, and muscle strength. During the examination, Dr. Shane J. Nho will perform specific physical exam maneuvers to evaluate the integrity of the hip joint and its surrounding structures.

Imaging Studies

Imaging studies are instrumental in visualizing the hip joint structures and identifying any abnormalities that may contribute to hip impingement. Given that the labrum is a soft tissue structure, it cannot be easily detected on normal x-rays. Thus, imaging modalities such as Magnetic Resonance Imaging (MRI) are key in confirming and characterizing a labral tear. MRIs give us the best view of the labrum at multiple angles, allowing Dr. Nho to make educated, research backed decisions on how to proceed with treatment.

Diagnostic Injections

In some cases, diagnostic injections may be used to confirm the source of hip pain and potential concurrent hip impingement. A local anesthetic and/or corticosteroid injection may be administered directly into the hip joint or surrounding structures under imaging guidance. If the injection provides temporary pain relief, it can help confirm the diagnosis and guide further treatment decisions.