31year old male presents with one month of ache and pain in the right hip after a soccer injury, he states while raising his knee to kick a ball his ankle was pushed down by another player. Pain is constant and aggravates when he elevates the knee. He has no pain in lying position and he can lay on the affected hip without discomfort. His past medical history is negative and he is healthy male, takes Glucosamine daily. Patient is bringing with him an MRI with contrast which is positive for Labrum tear.
Discussion: The labrum is a fibrocartilaginous rim which attaches to the acetabulum cavity (This is where the hip joint is located). Its job is to protect the femur (or the hip bone) and decrease any unevenness in its surface. The labrum is important since it decreases stresses between the joint surfaces, by producing a "sealing effect". It acts as a bumper which deepens the joint socket and helps keep the head of femur in place. The vascularity or blood flow is minimal which is not a good thing at all, this factor makes self healing hard to come by. Although not very specific the FABRE test (see picture) could be positive in presence of a tear. Here the examiner is anchoring patient's ankle against the opposite knee and pressing on the knee reproducing pain and tenderness in the anterior hip (medical lingo: front). MRI with contrast is a more specific test allowing the physician to actually visualize the tear. The condition is painful and annoying since it interferes with activities, This entity may be a risk factor future arthritis and problems to follow. This condition is not common at all but the several times that I have seen it it has involved aggressive physical activity such as jumping on a trampoline or sports injury.