MRI and Hip Labral Tears


We have a patient being treated with platelet-rich plasma. He has asked something interesting that is worthwhile discussing. He has MRIs for both hips that show some very mild arthritis, and they also incidentally show other things that are likely part of his degenerative process.

In one hip, the MRI mentions fraying of the labrum. In the other hip, the MRI mentions a small tear in the labrum.

The patient asked a really reasonable question: “What’s the difference, and is that even relevant?”

What’s interesting is, in somebody that has arthritis, that labral change is just part of that degenerative process. Understanding that goes a long way to not overreacting to it, despite what that MRI finding is.

Number two: Is there really that much of a difference between a small tear and a fraying tear, or fraying of a soft tissue segment in someone who already has osteoarthritis? And the answer is likely not.

We really looked at this individual clinically during his treatment. We looked at all the different layers of tissue, from the skin all the way down to the joint in his case, and even dynamically had him flex and internally, externally rotate the hip. And we noticed that there’s no impingement here. It’s not a labral issue.

But when you look at the different layers of tissue that are involved, you have muscles, tendons, ligaments, the labrum, the joint, and all of these are what’s causing his degenerative process in the hip.

For an individual like this, when he looks at his MRI report really carefully, he gets thrown off because there’s an emphasis on something like a labral tear versus labral fraying. When we look at it under ultrasound, and we realize the layers of tissue that are involved to lead to that slow and progressive degenerative issue going on in his hip.

He doesn’t need to overreact to this MRI, and it’s helpful in his case to realize that there is a layered process of what’s going on here, and that he doesn’t need to overreact and get overly concerned to what the MRI imaging report has, and in his case, he’ll likely do well.

He’s still at an early stage of his condition, and hopefully we can keep him functioning at a very high level, with a very low-intense, low-risk, nonsurgical process.