A hip labral tear involves the ring of cartilage, known as the labrum, that lines the outer rim of the hip joint socket. This structure deepens the hip socket, enhancing stability, creating a suction seal, and cushioning the joint to preserve cartilage health. When a tear occurs, common symptoms can include pain in the hip or groin, a sensation of clicking or catching within the joint, and stiffness or a reduced range of motion. These symptoms can sometimes overlap with other hip conditions, underscoring the importance of a thorough evaluation for an accurate diagnosis.
Key Clinical Assessment Maneuvers
Healthcare professionals perform specific physical examination maneuvers to evaluate the hip joint for conditions like a labral tear. These tests involve precise movements of the leg and hip to stress different parts of the joint and reproduce a patient’s symptoms. The findings from these clinical assessments guide further diagnostic steps.
The FADIR test, an acronym for Flexion, Adduction, and Internal Rotation, assesses for hip impingement and labral tears. During this test, the patient lies on their back while the examiner passively flexes the hip to 90 degrees, then adducts the leg across the body, and finally rotates the leg internally. This combination of movements compresses the femoral head against the front rim of the hip socket, potentially irritating an injured labrum.
The FABER test (Flexion, Abduction, External Rotation) is another maneuver. For this maneuver, the patient is positioned on their back, and the examiner places the hip into a “figure-four” position by flexing the hip and knee, abducting the thigh, and externally rotating the hip so the ankle rests on the opposite knee. Gentle downward pressure is then applied to the bent knee, which stresses the hip joint and surrounding structures. This test can help identify hip joint pathology, including issues with the labrum.
The Anterior Impingement Test targets the front and upper hip joint. This test involves passively moving the hip into flexion, adduction, and internal rotation. The movement aims to compress the femoral neck against the acetabular rim and anterior labrum. Reproduction of pain in the front of the hip during this maneuver suggests potential impingement or labral involvement in that area.
The Scour Test, also known as the Quadrant Test, assesses for hip joint pathology, including labral issues. With the patient lying on their back, the examiner flexes the hip and knee, applies an axial compression force through the femur, and then moves the hip through an arc of motion involving adduction and abduction. This grinding motion within the hip socket can provoke pain or mechanical symptoms if there is damage to the labrum or articular cartilage.
Interpreting Test Outcomes and Next Steps
A positive result for these physical examination tests means that the maneuver reproduces the patient’s familiar hip pain, causes a clicking or catching sensation, or reveals a limitation in movement. While these tests are valuable tools for a healthcare professional, a positive finding indicates a potential hip pathology, such as a labral tear, but it is not a definitive diagnosis on its own. These clinical maneuvers serve as important clues, guiding the clinician in their assessment.
Physical examination findings are evaluated in conjunction with a patient’s medical history and reported symptoms to form a comprehensive picture. To confirm a suspected hip labral tear, further diagnostic steps are often necessary. Medical imaging, such as a magnetic resonance arthrography (MRA), is commonly used. An MRA involves injecting a contrast material into the hip joint before the MRI scan, which helps to provide detailed images of the soft tissues, making a labral tear easier to visualize. This imaging can help differentiate a labral tear from other conditions that might cause similar symptoms.