Examination of acetabular labral tear: a continued diagnostic challenge
- 1Community and Family Practice, Duke University School of Medicine, Durham, North Carolina, USA
- 2Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
- 3Department of Physical Therapy, Walsh University, North Canton, Ohio, USA
- Correspondence to Dr Michael P Reiman, Community and Family Practice, Duke University School of Medicine, 2200 W. Main, Durham, NC 27705, USA;
- Accepted 25 June 2013
- Published Online First 31 July 2013
Acetabular labrum tears (ALT) are present in 22–55% of individuals with hip or groin pain. Tears can occur as a result of trauma or degeneration and are markedly associated with femoral acetabular morphological variations. An ALT can lead to biomechanical deficiencies and a loss of stability to the coxafemoral joint due to the labrum serving as a stabilising structure of this joint. The diagnosis of ALT is complex and multidimensional. Although tremendous improvements in diagnostic utility for ALT have occurred in the past 25 years, there are few patient history, clinical examination and special test findings that are unique to the condition. Imaging methods such as MRI, CT and ultrasonography have demonstrated reasonable accuracy, but not at a level that allows use as a stand-alone measure. Outcomes measures that focus on functional limitation or that are used to measure recovery should envelop the complexities of the condition and be captured using both self-report and physical performance measures. Only when patient history, objective testing, clinical examination special testing and imaging are combined can a clinician fully elucidate the multidimensional diagnosis of ALT.