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Acetabular Labrum Tears Can Be Misdiagnosed for Months

Most patients present with activity-related groin pain and see three or more providers before diagnosis

THURSDAY, July 27 (HealthDay News) -- Tears of the acetabular labrum can occur in young, active adults and often go undetected for months because patients present with a wide range of clinical symptoms and radiographs may not pick up the tear, according to a report in the July issue of The Journal of Bone & Joint Surgery.

R. Stephen J. Burnett, M.D., and colleagues from Barnes-Jewish Hospital at Washington University School of Medicine in St. Louis, reviewed the records of 66 patients with hip arthroscopy-documented labral tears, 47 of whom were female, to better understand the clinical characteristics associated with the injury. The mean age was 38 years.

Moderate to severe pain was reported by 86 percent of patients with the majority indicating groin pain. Most patients (91 percent) had activity-related pain and 71 percent had night pain, the researchers found. In addition, most had a positive impingement sign with some showing a limp or a positive Trendelenburg sign. The estimated average time from tear to diagnosis was 21 months with an average of 3.3 health care providers seeing the patient during this time. Eleven patients (17 percent) had another type of surgery recommended, and four patients had another type of surgery before the tear was diagnosed.

"In young, active patients with a predominant complaint of groin pain with or without a history of trauma, the diagnosis of a labral tear should be suspected and investigated as radiographs and the history may be non-specific for this diagnosis," the authors conclude.

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