Clinical features:
(1) Sometimes the patient gives a history of excessive twisting or a fall while running just prior to onset.
(1) persistent hip pain while running, often progressive
(2) anteromedial snapping or clicking
(3) intermittent hip instability
(4) intermittent hip locking
(5) decreased internal rotation of the hip
(6) The pain is relieved by injecting anesthetics and corticosteroids into the hip joint.
Maneurver to elicit pain in an anterior tear:
(1) start with the hip
flexed
, abducted and externally rotated
(2) move the hip to an
extended
, adducted and internally rotated position
Maneurver to elicit pain in a posterior tear:
(1) start with the hip
extended
, abducted and externally rotated
(2) move the hip to an
flexed
, adducted and internally rotated position while applying a posterior load
The most sensitive imaging study is MRI with gadolinium enhancement.
The most effective diagnostic method is arthroscopy, during which tears can be debrided or repaired.
