Labral lesions: an elusive source of hip pain case reports and literature review

Three cases are presented highlighting varied aspects of labral lesions as a primary or contributing source of mechanical hip pain; including one chronic labral tear associated with old trauma, an acutely entrapped labrum, and a degenerative labral tear associated with osteoarthritis. The diagnosis of labral lesions may be elusive. Arthrography, double-contrast arthrography followed by computerized tomography, and magnetic resonance imaging all have been reported in the assessment of these lesions with variable success. Often, the clinical presentation, including history and physical examination, will yield useful information. A fluoroscopically guided intra-articular injection of the hip is a very useful diagnostic tool for differentiating an intra-articular source of hip symptoms, such as labral lesions, from an extra-articular source. Labral tearing can readily be assessed by arthroscopy and many can be successfully addressed by operative arthroscopy. However, there are many variations in the arthroscopic anatomy of the acetabular labrum.