Acetabular labral tears

How does a doctor know my child has an acetabular labral tear?

Acetabular labral tears may be accompanied by other injuries and can require

• X-rays - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film

• Magnetic Resonance Imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.

At Children’s Hospital Boston, we know that the first step to treating your child’s acetabular labral tear is to form a timely, complete and accurate diagnosis. Our goal is to diagnose and treat her condition early in order to minimize her risk of developing arthritis (joint inflammation, resulting in pain, swelling, stiffness and limited movement) of her hip joint.

Physical exam tests
To diagnose an acetabular labral tear, your child’s doctor will take a complete medical and family history (including any hip problems in the family). The doctor will conduct a physical exam, which may include:

• an impingement test
  • flexion (bending)
  • adduction (movement inwards towards the body)
  • internal (for anterior tear) and/or external (for posterior tear) rotations of the hip joint)

If your child feels pain from these motions, a positive test has occurred and a tear is present.

• the McCarthy test
  • flexion (bending in both hips)
  • extension (straightening the affected hip)

If your child feels a catch during these motions, a positive test has occurred and a labral tear is present.

Imaging tests
To confirm a diagnosis, the doctor may order testing that can include:

• MRI (magnetic resonance imaging): produces detailed images of organs and structures within the body; shows the amount of damage to the labrum and other parts of the hip, such as cartilage and/or ligaments

·      x-ray: a radiographic picture of the inside your child's body to rule out a fracture or other damage to her bone, rather than to diagnose her acetabular labral tear

o   the oldest and most frequently used form of medical imaging

o   uses small doses of ionizing radiation to produce diagnostic pictures of the human body

arthroscopy (now rarely used for diagnostics at Children’s): diagnostic examination of the hip using an arthroscope—a thin, flexible fiberoptic scope introduced into the hip joint to assess the extent of damage to the labrum