Prefer to watch? 4-minute lesson13 slides · same content, shorter

1 · SNAPSHOT

Hip Labral Tear (± Chondral Lesion) body chart — Illustrative, not diagnostic. Canva body chart for Hip Labral Tear (± Chondral Lesion).

Who: Young to middle-aged. Running, field and rotational sport. Dancers.
What: Acetabular labral pathology, frequently with chondral involvement, sitting inside hip-related pain alongside FAI syndrome.
How it behaves: Anterior groin pain ± catching, clicking, locking or "giving way." Worse with pivoting, twisting and deep flexion — squats, getting out of the car.

The one thing to take from this page:

Labral tears are common in people with no hip pain at all. The finding doesn't separate the groups — the symptoms and the function do. Symptoms + function trump imaging.

The same finding, both groups

	People with hip pain	People without hip pain
Labral findings on imaging	Common	Common
What separates them	Symptoms. Function. Not the picture
Asymptomatic athletes	—	Studied specifically. Same story

⚠️ No guideline exists, and there is no randomised evidence on this page comparing repair with non-operative management. The comparative literature is cohort-level.

2 · SE — THE SUBJECTIVE PATTERN (the 70%)

Five stages, in your course's order. The mechanical symptoms are what earn this page over FAI syndrome — and they are also the ones patients over-report.

MAIN PROBLEM

"It catches and clicks in my groin."
"Twisting sets it off."
"It feels like it's going to give way."

BODY CHART

Anterior groin, deep. The C-sign grip again.
Mark lateral hip — coexisting gluteal tendinopathy.
Mark the adductor origin, symphysis and inguinal canal — the extra-articular entities are still on the list.
Buttock-dominant? Lumbar and SIJ.

BEHAVIOUR

	Fits labral pathology	Points elsewhere
Aggs	Pivoting, twisting, deep flexion, getting out of the car	Cutting and kicking with adductor tenderness → adductor-related
Severity	VAS 0–10 at best / at worst / right now	—
Symptoms	Catching, clicking, locking, giving way	Pinch without mechanical symptoms → FAI syndrome dominant
Onset	Gradual, or a traumatic twist	Sudden with functional loss → fracture, avulsion
Age	Young to middle-aged	Older with capsular restriction → hip OA and chondral change
Weight-bearing	Painful but able	Can't hop → bone stress

HISTORY

Traumatic twist, or gradual? Both stories occur.
Previous FAI-type symptoms? Common, and it is the same problem.
Sport and position — pivoting, cutting, dance, deep flexion.
What did the scan say, and who told them what? This is the barrier you will spend the appointment on.
Has anyone offered surgery?

SPECIAL / SCREENING QUESTIONS

True mechanical locking — the hip stuck, needing manipulation to free? That is different from clicking.
Can they hop? Night pain, RED-S profile → bone stress.
Adolescent with a traumatic mechanism? A missed posterior wall fracture alongside a labral tear has been reported in an adolescent athlete — trauma changes the imaging question.
Fever, weight loss, cancer history?

Assessing this region? Download the Hip & Groin assessment template →

3 · HYPOTHESIS RANKING

Competing pattern	The one discriminating feature
FAI syndrome	Overlaps almost completely. Morphology plus symptoms plus signs. Treat as one hip-related pain problem, not two diagnoses.
Hip osteoarthritis / chondral lesion	Older, capsular restriction — and chondral involvement changes the prognosis conversation.
Adductor- or iliopsoas-related groin pain	Tender at the tendon, pain on the matching resisted test. Extra-articular.
Lumbar or SIJ referral	Back or buttock behaviour; the hip tests don't reproduce it.
Ballet and dance populations	Worth naming separately. Read further: prevalence in professional ballet dancers alongside sporting participants [1].

The two that outrank the table

Femoral neck stress fracture. Same population, same location, and the one you cannot miss.

A missed fracture alongside the labral finding. A posterior wall fracture missed alongside a labral tear in an adolescent athlete is a reported failure mode — a traumatic mechanism changes what the imaging needs to answer.

And the pearl that decides the plan

Watch for early osteoarthritic and chondral signs in older athletes. It matters because chondral involvement changes what you tell them about the future — not just what you do this week.

4 · RED FLAGS — DON'T MISS THIS

This section is free, on every pattern, forever. Safety is never gated.

Finding	What it suggests	What you do
Groin pain with inability to weight-bear or hop	Femoral neck stress fracture	Urgent imaging. Do not load
Night pain or rest pain	Bone stress, infection, tumour	Image
RED-S profile — low energy availability, menstrual disturbance	Bone stress injury	Image and refer
Traumatic mechanism in an adolescent	Fracture alongside the labral finding	Image properly
Adolescent with a limp and restricted IR	Slipped capital femoral epiphysis	Urgent imaging and orthopaedic review
True mechanical locking	Displaced tear, loose body	Orthopaedic review
Hot, swollen, exquisitely painful hip with fever	Septic arthritis	Emergency
Cancer history with new hip pain	Metastatic disease	Medical review
Young adult hip pain with IV drug use, alcohol excess or corticosteroid use in the history	Fracture, infection or ischaemic necrosis must be ruled out early	Image and refer before you treat it as labral (Troum & Crues 2004) [21]

The rule: position- and rotation-related groin pain with mechanical symptoms, in someone who can hop with a clean systemic screen, is yours. Weight-bearing pain, night pain, a traumatic adolescent hip or true locking is not.

Cross-links: Femoroacetabular impingement · Hip osteoarthritis · Adductor-related groin pain · Iliopsoas-related pain

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The 4-minute lesson is for members

Twelve slides on this pattern: what you'll hear, what to examine, what to do. Free with an account.

Guideline anchor

No guideline covers hip labral tears.

Anchored to the consensus on classification and diagnostic criteria for hip-related pain in young and middle-aged active adults (Reiman et al. 2020, PMID 31959678), which places labral pathology inside hip-related pain rather than beside it; to the Warwick Agreement (Griffin et al. 2016, PMID 27629403); and above all to the asymptomatic-prevalence literature (Register et al. 2012, PMID 23104610; Heerey et al. 2018, PMID 29540366; Heerey et al. 2019, PMID 30972659), which is why the page's first pearl carries the whole page.

PubMed Source

Both anchors are consensus statements, not guidelines, and neither is Australian. There is no randomised evidence on this page comparing repair with non-operative management; the comparative literature is cohort-level.

Members

The evidence summary is for members

Verified diagnostic accuracy, where the evidence stands and what it doesn't settle. Free with an account.

Sources · 20

Show

Every source on this page resolves and title-verifies against PubMed. Newest first.

2016Mayes et al. (2016). Similar Prevalence of Acetabular Labral Tear in Professional Ballet Dancers and Sporting Participants. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 26(4), 307-13. https://doi.org/10.1097/JSM.0000000000000257
2015Reiman et al. (2015). Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: a systematic review with meta-analysis. British journal of sports medicine, 49(12), 811. https://doi.org/10.1136/bjsports-2014-094302
2014Reiman et al. (2014). Examination of acetabular labral tear: a continued diagnostic challenge. British journal of sports medicine, 48(4), 311-9. https://doi.org/10.1136/bjsports-2012-091994
2009Troelsen et al. (2009). What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?. Acta orthopaedica, 80(3), 314-8. https://doi.org/10.3109/17453670902988402
2019Gao et al. (2019). The Diagnostic Value of Ultrasound in Anterosuperior Acetabular Labral Tear. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 35(9), 2591-2597. https://doi.org/10.1016/j.arthro.2019.02.052
2022Fu et al. (2022). Quantitative and Qualitative Ultrasound Evaluation for the Diagnosis of an Anterosuperior Acetabular Labral Tear. Ultrasound in medicine & biology, 48(5), 924-932. https://doi.org/10.1016/j.ultrasmedbio.2022.01.016
2013Ha et al. (2013). The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation. Skeletal radiology, 42(5), 681-8. https://doi.org/10.1007/s00256-012-1528-9
2014Liem et al. (2014). Nonoperative management of acetabular labral tear in a skeletally immature figure skater. PM & R : the journal of injury, function, and rehabilitation, 6(10), 951-5. https://doi.org/10.1016/j.pmrj.2014.04.001
2015Khoo-Summers & Bloom (2015). Examination and treatment of a professional ballet dancer with a suspected acetabular labral tear: A case report. Manual therapy, 20(4), 623-9. https://doi.org/10.1016/j.math.2015.01.015
2016Narveson et al. (2016). Management of a Patient With Acute Acetabular Labral Tear and Femoral Acetabular Impingement With Intra-articular Steroid Injection and a Neuromotor Training Program. The Journal of orthopaedic and sports physical therapy, 46(11), 965-975. https://doi.org/10.2519/jospt.2016.6573
2023Hyland SS et al. (2023). Comparative analysis between operative and non-operative acetabular labral tear injuries in division 1 collegiate athletes. Scientific reports, 13(1), 9461. https://doi.org/10.1038/s41598-023-36454-0
2026Woodrow et al. (2026). Impact of Acetabular Labral Tear Location on Patient-Reported Outcomes and Conversion to Total Hip Arthroplasty After Hip Arthroscopy With an 8-Year Minimum Follow-up. Orthopaedic journal of sports medicine, 14(4), 23259671261432671. https://doi.org/10.1177/23259671261432671
2026Chenna et al. (2026). Long-term Outcomes and Conversion to Total Hip Arthroplasty Based on Acetabular Labral Tear Size: Minimum 8-Year Follow-up. Orthopaedic journal of sports medicine, 14(2), 23259671251410207. https://doi.org/10.1177/23259671251410207
2012Register et al. (2012). Prevalence of abnormal hip findings in asymptomatic participants: a prospective, blinded study. The American journal of sports medicine, 40(12), 2720-4. https://doi.org/10.1177/0363546512462124
2016Griffin et al. (2016). The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. British journal of sports medicine, 50(19), 1169-76. https://doi.org/10.1136/bjsports-2016-096743
2018Heerey et al. (2018). What is the prevalence of imaging-defined intra-articular hip pathologies in people with and without pain? A systematic review and meta-analysis. British journal of sports medicine, 52(9), 581-593. https://doi.org/10.1136/bjsports-2017-098264
2019Heerey et al. (2019). What is the Prevalence of Hip Intra-Articular Pathologies and Osteoarthritis in Active Athletes with Hip and Groin Pain Compared with Those Without? A Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.), 49(6), 951-972. https://doi.org/10.1007/s40279-019-01092-y
2020Reiman et al. (2020). Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018. British journal of sports medicine, 54(11), 631-641. https://doi.org/10.1136/bjsports-2019-101453
2022Kwon et al. (2022). Acetabular labral tear is associated with high pelvic incidence with or without femoroacetabular impingement morphology. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 30(10), 3526-3534. https://doi.org/10.1007/s00167-022-06881-z
2025Dhillon & Kraeutler (2025). Why Do You Focus on the Acetabular Labral Tear? You Can't See the Forest for the Trees. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 41(3), 539-540. https://doi.org/10.1016/j.arthro.2024.10.052

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