University of Occupational and Environmental Health Wakamatsu Hospital
orthopedics・Sports arthroscopy
Wakamatsu Hospital for University of Occupational and Environmental Health
Orthopedic and Sports Arthroscopy Surgery
ISAKOS approved Teaching Center
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What is acetabular labral tear?
Anatomy and function of the hip labrum
Anatomy and Function of Acetabular Labrum
The hip joint is called a ball-and-socket joint, and the acetabulum on the pelvic side has a strong fibrous cartilage around it called the hip labrum. The hip labrum is configured around the socket like a rubber gasket that sticks around the femur, creating a hard seal that helps stabilize the hip joint.
The hip labrum also deepens the acetabulum, increasing the surface and strength of the hip joint.
Hip joint is so-called as ball and socket joint. the joint.
A ring of fibrocartilage (fibrous cartilage) that runs around the acetabulum (cup) of the hip joint and increases its depth.labrumdeepens this cavity and effectively increases the surface (and strength) of the hip joint.
Causes of hip labrum injury
Cause of acetabular labral tear
What causes hip labrum?
It is believed to be mainly caused by the following six causes.
trauma,
degeneration (changes with age),
Capsular laxity (people with naturally loose joints)
femoral acetabulum impingement
Anterior inferior iliac spine impingement
acetabular dysplasia,
How labral injuries occur;
The six most common causes of acetabular labrum tears are:
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trauma
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degeneration
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capsular laxity
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Femoro-acetabular impingement.
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Anterior Inferior Iliac Spine Impingement
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hip dysplasia (congenital abnormality)
Diagnosis of hip labrum injury
Diagnosis of acetabular labral tears
Symptoms Symptoms
Often sharp, sometimes dull pain in the buttocks, often from the groin to the outside of the hip jointPain may be felt in the movement of the hip joint.
Sometimes getting in and out of a car is painful and resting relieves the pain.
In some cases, you may feel a clicking or sticking sensation.
You may experience pain, often sharp, but sometimes dull, in the groin or buttock during certain activities or certain movements of the hip joint. Sometimes you may have pain getting into/out of a car or seated position. You may have no pain or symptoms while at rest. Occasionally, you may have a clicking or catching sensation.
How to diagnoseHow is it diagnosed?
Most patients can be diagnosed by history, physical examination, and MRI.
The medical history is examined for common symptoms of hip pain, and the physical examination includes the anterior impingement test (FADIR test), FABER test, and hip dial test to rule out other causes of disease. Plain radiographs look for bone abnormalities and determine if there is femoroacetabular impingement (FAI).
Most patients can be diagnosed with a good history, physical exam, and an MRI. A patient's history will generally involve complaints of hip pain as described above._cc781905- 5cde-3194-bb3b-136bad5cf58d_ The physical exam including Anterior impingement test (FADIR test), FABER test and Hip Dial test will generally confirm the patient's history and eliminate other causes of hip pain._cc781905-5cde- 3194-bb3b-136bad5cf58d_ Plain x-rays may be completely normal or may demonstrate some signs of femoro-acetabular impingement (see pamphlet on FAI).
The best diagnostic information is obtained by injecting a local anesthetic and performing a pain test when injecting a contrast agent into the joint for MRI.
Contrast-enhanced MR can rule out other diseases such as head necrosis and tumors. /
Recently, 3 Tesla MR has progressed, and it has become possible to detect hip labrum injuries without a contrast medium.
An MRI study with intraarticular gadolinium (contrast dye in the joint) and a pain test provide the most diagnostic information. The pain test typically involves placing a local anesthetic inside the hip joint with the contrast dye. Using the pain test helps assess whether the pain is coming from inside the hip joint. The MR Arthrogram is most helpful in eliminating certain causes of non FAI hip pain recently, 3 tesla MRI has been evolving to detect acetabula labral tear without dye.
