Patient History
49-year-old woman with pain radiating down her leg that is not relieved by cortisone injection
Findings
SKELETAL: Mild asphericity of the head/neck junction with an alpha angle measured at 60.32 degrees. Findings may contribute to pincer morphology and biomechanics as a large labral tear is present to be described. Acetabular cup depth is slightly shallow.
Incidentally noted is lumbar spondylosis and degenerative disc disease with loss of disc space height, especially at L5-S1.
PELVIS: Incidentally noted is a 2.5 x 3 cm left adnexal cyst in a perimenopausal patient. Incidental cervical nabothian cyst.
JOINTS: 1+ effusion. No intra-articular bodies. No synovitis.
ACETABULUM/LABRUM: Extending from the antero-mid hip joint, e.g. 9 o’clock to the 12 o’clock position superior on the femoral head, is a complex detached labral tear or frank chondrolabral detachment.
MUSCLES/TENDONS/LIGAMENTS: Abductors, adductors, flexors and extensors unremarkable. No soft tissue masses.
OTHER/SOFT TISSUE: Generalized periarticular swelling.
Conclusion
Large antero-mid 9 o’clock to superior 12 o’clock labral tear with labral detachment. Asphericity and elevated alpha angle suggest pincer biomechanics.
