Labral Tears on Hip MRI

[@Danny37651]

I have a labral tear I’m 27 and have been told for 2 years to do physio without an MRI scan I’m finally having surgery thank you NHS I’m now guaranteed arthritis

[@jakey20022]

I had a partial tear which was causing inflammation to run down my thigh and felt like my thigh was on 🔥.

[@Danny37651]

@@jakey20022 did you get it sorted

[@SpokeNipples]

I waited 3 years for hip labrum repair surgery with the nhs. After that experience I now have Bupa healthcare

[@nostalgictarot5744]

Surgery recovery update?

[@MrsJHarrington]

I’m 46 I had surgery last year for the same issue and I may end up having to have another surgery because I still am not walking correctly and I have been in physical therapy for almost a year. I’m also guaranteed arthritis is a hip replacement. I pray that you will be OK after your surgery.

[@reshmakissoon]

My MRI showed ligaments torn on my right hip. I have been going for physio and chiro for 2 years since my fall. And finally my orthopaedic surgeon found the identified the cause of my pain on the MRI. I have since gone for surgery to repair my ligaments and muscle. 6 weeks in recovery, very painful Thanks for sharing

[@AmethystWoman]

I have had severe hip/buttocks pain from a fall in March. An MRI of my spine was done which shows multiple disk herniations from L2 to S1 but we knew this. I've had 4 back surgeries. I always have back pain. No big deal. But the hip pain. Very big deal. It's been 5 months and I have not been able to get an orthopod to look into my hip. Finally my PCP stepped out of her lane and ordered an MRI of my hip. Two labral tears. Anterior and Anterior superior. No mention of thickness of tear. (I am a retired nurse and still couldn't get anyone to listen to where the pain actually was.) I have been in PT for 5 months now with each week getting worse. My PT has apparently been concerned about an AVN, which I didn't know, but all she could do was send notes to my PCP and the emergency clinic doctor who referred me. I'm sure he never saw her notes. I went to two other surgeons. Both wanted to inject my back without telling me where and why. I've been 5 months mostly in bed/chair and on crutches. Now, because of the time frame, the ball of my hip is flattened and the acetabulum is mishappen. The fix for me now is a total hip replacement sadly. Though I guess at 69, that's easier than a labral tear repair esp since running is not in my future. Thanks for this.

[@drumsdoc]

Great videos. Can you also show 1-2 cases that were more tough to call? We all know how radiology is full of gray areas, and an expert showing how to assess a difficult case would be really helpful.

[@DrChristophAgten]

That is actually a good idea. Thanks

[@stevejodoin9937]

The examples shown are nice. Really nice.

[@DrChristophAgten]

thx steve

[@umit777.]

What did you do

[@israakhalil3135]

Hi Dr.Agten, can you see the cartilage delamination on MRI without contrast ?

[@angelesreynosa38]

Do you have any examples where there is a cyst around the Labrum?

[@hineighbor]

If I continue to run with a torn hip labrum, could it become worse? Could I be causing long term damage? Or has the damage been done? I just want to be able to run

[@AmethystWoman]

Because I was not treated for my tears for months, I now will need a total hip replacement as the hip bones become mishappen. You can't run on a THR. So if I were you, I'd stop running and get it fixed. Yes, it can get much worse including avascular necrosis of your hip joint and YOU DON'T want that!

[@sherrycothron9061]

What is hip labrum tear with overlapping ? Whar to do about this ? Thank you.

[@anshurajput.]

Hello sir What is the means of minimum displacement tear of acetabulum And right hip joint effusion

[@gailmackenney303]

Thank you for the video. Do you believe identifying and analyzing labral tears is better with MRI or with MRA (magnetic resonance arthrogram) ?

[@catnipcat1762]

I was wondering if MRA is necessary(?). What are the ramifications if a patient requests MRI only? Would that increase surgical risks or increase chance of poor outcome? From what I’ve read, MRA poses risk as well-is it truly needed?

[@jenw5260]

Can you clarify for me : probable prominent right superior sublabral sulcus with no discrete labral tear right hip

[@Hyoshow]

Is this mri with or without contrast

[@DrChristophAgten]

normally we do intra articular contrast (MR arthrography)

[@lorrainecolerealestate9138]

I live in US. My Consultant thinks I have a labral tear and has ordered an MRI (without contrast). As I'm acutely claustrophobic, I'm getting fully sedated with a GA. I am thinking that if I have a GA, just so I can cope with an MRI, wouldn't it make sense to ask that the MRI is with contrast? I want the best shot at getting as informative an MRI as possible first time round. Do you have any thoughts/advice for me? Thank you for any help!

[@emilyw8646]

Do all tears require surgery eventually? Which types are more likely to need surgical repair over physical therapy? How would I be able to show you a picture and get feedback from my mri photo?

[@martinfricek4787]

Please, what means a paralabral cyst of the hip joint? What diseases makes the joint to develop a cyst? Can the cyst trap nerves or reduce a blood flow to leg muscles. due to it's size?

[@pablobarroso1589]

Does anyone have a popping sensation when walking normally ? I had an mri done and thought it was illiopsoas muscle but but doctor said it’s a chondrolabral separation but it pops every time I walk normally

[@arseniocavada1473]

Hi Christoph. What traction system do you use for hip arthroRm?

[@apikasol2855]

Hi, can you see and identify a labrum tear on MRI without the contrast?

[@DrChristophAgten]

Yes

[@diannahill9430]

I have labral tears on both hips. The left hip is way worse than the right I got a cortisone injection this week. Feeling some better now

[@AmethystWoman]

Except that doesn't fix the tears and things will continue to get worse but the pain hidden for a while. The injection of not curative of course. Best of luck.

[@thomashelm6931]

No amount of injections relieve my pain. I'm glad this was effective for you!

[@CityMedik]

Excelent video. Thank you :)

[@megang4990]

Love the video! I got mri results and I have a FAI, posterior subpleural sulcus, and a acetabuli notch could you give me any information on the sulcus or why it could be cause if me so much pain? Also would they do surgery on it thank you!

[@DrChristophAgten]

Can't comment without the images im afraid

[@neuroradnerd]

Hi Dr. Agten, please may you recommend me a paper on the labral tears by plain film in the pediatric population?

[@DrChristophAgten]

wrong modality, i suggest pubmed.gov

[@mikelai644]

Can you get paralabral cysts with partial thickness labral tears?

[@DrChristophAgten]

you could get intralabral cysts, paralabral would require some stuff going through the labrum so i would say not, but maybe that is an academic discussion :)

[@Dani-ICU-RN]

So, TY ! I'm an ICU nurse for 22 years.51 yr old. I have been limping on & off for long time. My neck/ back have hurt since Day 1 as a nurse! Although I'm an ICU nurse, we don't get many ortho pts,therefore, this is new to me.I have Rt hip& shoulder labral tears..OA, DJD, and as a bonus. A fx left toe from limping! Should I find 1 DR, or, a hip DR, and a shoulder MD ? I'm scared to death to have surgery, but I can barely get in/out of my SUV, cant walk far,can't sleep from the pain....😢. I have no income & 2 daughters...Which should I do 1st? ..TYTY! I'M in South Florida.Id be happy to send you films if you need more pics!

[@umit777.]

​@@Dani-ICU-RNhi what did you do for labral tear. How are you now

[@lindakelsch6196]

I was reading where a MRA/MRI is preferable to MRI...would MRI be just fine?

[@DrChristophAgten]

MRA will be a bit better. Mind that meta-analysis in this area often include old studies with ugly images....

[@HeyIntegrity]

@@DrChristophAgten is bilateral hip mri done with a torso coil in one go as good as a normal hip mri(one side) for labral tear detection?

[@VickiMartin-v9c]

@@DrChristophAgten I think MRA requires GA, is that right? One surgeon told me so. There is enormous difference in practice, some insist on sedation just for diagnostic injection of local/steroid. Anaesthetists say I have GA risks (my cardiologist cannot understand why) so it's not an easy option for me if GA required. Have had MRI (posted results in a reply elsewhere in these comments).

[@mynameisburhanaltintop]

Anyone having hip labral tear problem in the UK. Still waiting for an appointment . How did yours go thorugh NHS? Thanks

[@VickiMartin-v9c]

Did you eventually get there? I'm UK also. I think UK is way behind USA. I've had to research heavily in order to fight my case. Physio suspected posterior labral tear (coming up for 6 months of pain), nearest private surgeon couldn't see me for 2-3 months (but then hey presto offered me an appointment in 2d when I threatened to go to someone else), asked me how old I was (58), didn't do test specific to posterior tear, then suggested based solely on slightly reduced joint space on xrays that he suspected I was going to be a candidate for hip replacement in 5-8y. I am not sure how I drove home I was so shocked. Xray also showed combined FAI. MRI then done, radiologist report said labrum intact (I have queried this and asked them to review the report) but by this time I'd had the scan transferred to a different surgeon elsewhere, he saw labral fissuring and cystic changes, plus zero indication of needing hip replacement. First surgeon has just bumped me along, long waits for more tests etc (NB this is private but he's also NHS). I'm now travelling 2-3h away to see someone else (I also have general anaesthetic risk considerations: 80% of hip arthroscopy in some USA hospitals is done under spinal but it's very difficult to find anyone offering it in UK). I am pretty appalled.

[@amjgbaobei]

Were any or all of these MRIs done with contrast? (MRA)? My doctor says that it’s unnecessary to do an MRI with contrast. I’m confused. Why would he say this?

[@gayanekrikorova5849]

I fell while hiking a couple of months ago and my left hip has been bothering me ever since. I had an MRI done (without contrast) and they said my hip is perfect. Is it possible that the MRI would not show the tear? Or could it be something else? I’m dying to hike again, it’s my life.

[@howardwager]

You need mri with contrast.

[@litespeed7715]

How can you tell if the contrast is injected properly when looking for a labral tear? My niece suffered a hip labral tear and apparently the imaging lead to a false negative. She just recently completed a second MRI and this time the tear shows up clear as day.

[@abbeybateman4899]

Very helpful!

[@DrChristophAgten]

thank you Abbey!

[@c.tucker95]

What does it mean if radiographs say fraying legementum teres?

[@DrChristophAgten]

it shouldnt say it on radiographs. you mean probably MRI, so it means its not quite normal anymore, like an old frayed rope

[@c.tucker95]

@@DrChristophAgten yes, MRI, I spoke wrong, I've had plenty of MRI's that is for sure. I dont have a problem with that. What I do have a problem with is how I was referred and got recommendation yet vamc still didnt let me go for treatment. So how come the referral to begin with. So, back to this fraying legementum teres. Who should I see in order to get help with such a thing. I'm having a hard time walking now and I've got multiple old injuries and age wearing on my joints. I could use some pointers, help from pt, medical masseuse &possibly even surgery (?) I'd like to not have surgery if possible. If you have a mechanic you can trust and a doctor you can trust, I reckon you've got it made. I have had neither. Dr Christoph, what kind of questions should I be asking them about this fraying legementum teres? I need help as far as direction here. It's quite overwhelming but as long as I have a pulse, I will be fighting to get my health back.

[@DrChristophAgten]

@@c.tucker95 , obviously i cannot give medical advise for you specifically, i have not seen the images, I do not know your story completely, also I cannot give specific advice if you are US or Canadian citizen or live there due to indemnity insurance stuff. Just a general comment: fraying of the ligamentum teres is hardly relevant, and some experts question its potential as a pain generator. However, young athletes might get tears or partial tears of the ligament, or everybody after hip dislocation will have a rupture of the ligament, so fraying alone per so is probably not an important finding and certainly no indication of hip arthroplasty. You mention old injuries and probably osteoarthritis, that is probably more likely to cause problems then changes in the ligamentum teres (again, more generally speaking, not to you). in such cases one way to go would be a second opinion.

[@MarthaHernandez-oc3wv]

My 17 year old daughter has a labral tear in her right hip and her orthopedic doctor told us that she might need surgery because physical therapy just made the pain worse. We have read that continuing constant movement of the hip can be beneficial but working out hurts the area. We have also been told that injections which I can’t remember the name of at the moment can help but arthritis runs in the family and we have seen some doctors say that the hip can eventually get worse. We were recommended to a surgeon and she is on a prescription of Advil 400 mg 3x a day for the pain and it still bothers her every once in a while. We have another appointment soon, what other questions should we ask? Any more treatment options to do? Any recommendations?

[@DrChristophAgten]

Can't give individual advice. But generally it's important to know that many labral tears are asymptomatic, so a good questions could.be, can it be something else?

[@jvcarter21]

Just get the surgery. I had the same problem. Did everything u said and it got worse after surgery. After I got my surgery my doctor told me he was un able to repair it because it was torn so bad. So he took out my labrum completely and now I have to get a labrum replacement in the future.

[@Hyoshow]

Hello, did she end up getting the surgery?

[@YogalignKauai]

@@DrChristophAgten Since labral tears can by asymptomatic, I have been using posture realignment techniques allowing people to get out of pain without getting surgery. kzbin.info/www/bejne/e6mrlqqaoZiInsU

[@umit777.]

​@@jvcarter21oh my god what did you do. How are you now

[@TheTkndnv]

Hello. Would you be able to review my MRI images for me (paid of course)? I would be really grateful as I do not believe the company I used knew what they were looking for.

[@chilionski9643]

is it good or normal for a 18 year old to have a Labral tear ?

[@DrChristophAgten]

no, it is definitely not good, and not the norm

[@Hyoshow]

Do you still have one or did you get it treated? I’m 22 and I think I have one

[@rokometer8]

I had both hips done at 18

[@umit777.]

​@@rokometer8 what is your labrum now. How do you feel

[@josealejandrobv]

1st comment!

[@DrChristophAgten]

lucky you, this video is online for some time already :)

[@c.tucker95]

I Cant believe I almost let the vamc do hip replacement surgery on me. All the while I had fraying legementum teres.

[@DrChristophAgten]

second opinions are a great way before such significant surgeries

[@thomashelm6931]

Is this the VA?? I found them to be absolutely worthless when it came to diagnosis and treatment of a labral tear. Thank goodness I have Medicare or I'd be dead