Hip labral tear Flashcards
Hx
33 yr old M gaelic footballer 3 month hx of R hip and groin pain worse when running and jumping and eased with rest. Intermittent snapping feeling over r hip on certain movements and a locking sensation. No hx of trauma and no PMHx
look/ inspection
antalgic gait
feel
nil of note
no pubic symphysis, greater trochanter or groin tenderness
active and passive movement
pain/ clicking during active ROM non-specific
resisted movement
nil of note
ant labral tear findings
pain on movement of hip from a fully flexed abducted and rotated laterally position to an extended medially rotated and adducted position
post labral tear findings
pain on movement of hip from a fully flexed adducted and rotated medially position to an extended, laterally rotated and abducted position
DDx
labral tear of hip osteitis pubis trochanteric bursitis osteoarthritis R hip hip dysplasia
why is labral tear of hip likely?
Hx pain worse with running/jumping
Exam pain during AROM and PROM hip. Postive ant labral provocative test
why is osteitis pubis unlikely?
no localised tenderness over the pubic symphysis
why is trochanteric bursitis unlikely?
no tenderness over the greater trochanter
why is OA R hip unlikely?
relatively young age, painful clicking during AROM/PROM not classically a/w OA hip
why is hip dysplasia unlikely?
no previous hx of hip problems from childhood
investigations
X ray AP pelvis
MRI Arthrogram
X ray AP pelvis to rule out
hip dysplasia
osteoarthritis
acetabular cysts
