From the Guidelines
A patient with a hip labral tear would most likely experience deep groin pain, clicking or locking sensations in the hip, stiffness, limited range of motion, and pain that worsens with activity, particularly movements that involve hip rotation. The terminology "superior labrum tear" is typically used for shoulder injuries (SLAP tears), not hip injuries. In the hip, labral tears are classified by their location (anterior, posterior, or lateral) rather than superior or inferior. These symptoms occur because the labrum helps keep the femoral head securely within the acetabulum (hip socket) and contributes to joint stability and proper movement. When torn, the labrum cannot function properly, leading to these characteristic symptoms. Some key points to consider when evaluating hip-related pain include:
- The most common hip conditions in young and middle-aged active adults presenting with hip-related pain are femoroacetabular impingement (FAI) syndrome, acetabular dysplasia and/or hip instability, and other conditions without a distinct osseous morphology (labral, chondral and/or ligamentum teres conditions) 1.
- Clinical examination and diagnostic imaging have limited diagnostic utility; a comprehensive approach is therefore essential 1.
- Diagnostic imaging demonstrates post-test probability shifts ranging from very small to substantial for the diagnosis of FAI syndrome, and acetabular dysplasia and/or hip instability, and small to moderate shifts at best for labral, chondral and ligamentum teres pathology 1.
- Diagnosis of the primary cause of hip-related pain should never be made using imaging alone, but rather should consider symptoms and clinical signs 1.
- Anteroposterior (AP) pelvis and lateral femoral head–neck radiographs, as well as MRI/magnetic resonance arthrogram (MRA) or CT scan, can be used to assist in diagnosing hip conditions characterized by hip-related pain 1. The pain may also radiate to the buttock or along the side of the thigh, and patients may present with a history of hip catching or locking, as noted in a study on chondral injuries of the hip 1. Diagnosis typically requires imaging such as MRI arthrography, and treatment options range from conservative management with physical therapy to surgical repair depending on severity. It is essential to consider the patient's symptoms, clinical signs, and diagnostic imaging results when making treatment decisions, as recommended by the International Hip-related Pain Research Network 1.
From the Research
Symptoms of a Superior Labrum Tear of the Hip
- Anterior groin pain
- Pain in hyperflexion
- Sharp catching pain with rotation 2
- Anterior hip or groin pain
- Buttock pain (less common)
- Mechanical symptoms including clicking, locking, and giving way 3
Diagnostic Considerations
- A cluster of symptoms including anterior groin pain, pain in hyperflexion, and sharp catching pain with rotation can make a diagnosis of a labral tear more likely 2
- A positive anterior hip impingement test is a consistent physical examination finding 3
- Radiographs, including a minimum of a standing anteroposterior pelvis and 45° Dunn view, should be obtained in all patients presenting with a suspected labral tear 2
- Magnetic resonance arthrography (MRA) is the diagnostic test of choice, with arthroscopy being the gold standard 3