Skeletal Radiology

, Volume 36, Issue 5, pp 391–397 | Cite as

Classification and localization of acetabular labral tears

  • D. G. BlankenbakerEmail author
  • A. A. De Smet
  • J. S. Keene
  • J. P. Fine
Scientific Article



The purpose of this study was to compare the findings on hip MR arthrography (MRA) with the published MRA and arthroscopic classifications of hip labral tears and to evaluate a clock-face method for localizing hip labral tears.


We retrospectively reviewed 65 hip MRA studies with correlative hip arthroscopies. Each labrum was evaluated on MRA using the classification system of Czerny and an MRA modification of the Lage arthroscopic classification. In addition, each tear was localized on MRA by using a clock-face description where 6 o’clock was the transverse ligament and 3 o’clock was anterior. These MRA findings were then correlated with the arthroscopic findings using the clock-face method of localization and the Lage arthroscopic classification of labral tears.


At MRA, there were 42 Czerny grade 2 and 23 grade 3 labral tears and 22 MRA Lage type 1, 11 type 2, 22 type 3 and 10 type 4 tears. At arthroscopy, there were 10 Lage type 1 flap tears, 20 Lage type 2 fibrillated tears, 18 Lage type 3 longitudinal peripheral tears and 17 Lage type 4 unstable tears. The Czerny MRA classification and the modified MRA Lage classification had borderline correlation with the arthroscopic Lage classification. Localization of the tears using a clock-face description was within 1 o’clock of the arthroscopic localization of the tears in 85% of the patients.


The Lage classification, which is the only published arthroscopic classification system for hip labral tears, does not correlate well with the Czerny MRA or an MRA modification of the Lage classification. Using a clock-face description to localize tears provides a way to accurately localize a labral tear and define its extent.


MR arthrography Hip Labral tears 


  1. 1.
    Czerny C, Hofmann S, Neuhold A, Tschauner C, Engel A, Techt MP, et al. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology 1996;200:225–30.PubMedGoogle Scholar
  2. 2.
    Hodler J, Yu JS, Goodwin D, Haghighi P, Trudell D, Resnick D. MR Arthrography of the hip: improved imaging of the acetabular labrum with histologic correlation in cadavers. AJR 1995;165:887–91.PubMedGoogle Scholar
  3. 3.
    Petersilge CA, Haque MA, Petersilge WJ, Lewin JS, Lieberman JM, Buly R. Acetabular labral tears: evaluation with MR arthrography. Radiology 1996;200:231–35.PubMedGoogle Scholar
  4. 4.
    Fitzgerald Jr. RH. Acetabular labrum tears; diagnosis and treatment. Clin Orthop 1995;311:60–8.PubMedGoogle Scholar
  5. 5.
    Petersilge CA. From the RSNA refresher courses: chronic adult hip pain: MR arthrography of the hip. Radiographics 2000;20:S43–S52.PubMedGoogle Scholar
  6. 6.
    Petersilge CA. MR arthrography for evaluation of the acetabular labrum. Skeletal Radiol 2001;30:423–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Lage LA, Patel JV, Viller RN. The acetabular labral tear: an arthroscopic classification. Arthroscopy 1996;12:269–72.PubMedCrossRefGoogle Scholar
  8. 8.
    Dorrell JH, Catterall A. The torn acetabular labrum. J Bone Joint Surg 1986;68-B:400–3.Google Scholar
  9. 9.
    McCarthy J, Noble P, Aluisio FV, Schuck M, Wright J, Lee J. Anatomy, pathologic features, and treatment of acetabular labral tears. Clin Orthop 2003;406:38–47.PubMedCrossRefGoogle Scholar
  10. 10.
    McCarthy JC, Busconi B. The role of hip athroscopy in the diagnosis and treatment of hip disease. Otrhopedics 1995;18:753–6.Google Scholar
  11. 11.
    Hase T, Ueo T. Acetabular labral tear: arthroscopic diagnosis and treatment. Arthroscopy 1999;15:138–41.PubMedCrossRefGoogle Scholar
  12. 12.
    Ikeda T, Awaya G, Suzuki S, Okada Y, Tada H. Torn acetabular labrum in young patients: arthroscopic diagnosis and management. J Bone Joint Surg 1988;70-B:13–16.Google Scholar
  13. 13.
    Mohana-Borges AVR,Chung C, Resnick D. Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography. AJR 2003;181:1449–62.PubMedGoogle Scholar
  14. 14.
    Leunig M, Podeszwa D, Beck M, Werlen S, Ganz R. Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingment. Clin Orthop 2004;418:74–80.PubMedCrossRefGoogle Scholar
  15. 15.
    Czerny C, Hofmann S, Urban M, Tschauner C, Neuhold A, Pretterklieber M, et al. MR arthrography of the adult acetabular capsular-labral complex: correlation with surgery and anatomy. AJR Am J Roentgenol 1999;173:345–9.PubMedGoogle Scholar
  16. 16.
    Petersilge C. Imaging of the acetabular labrum. Magn Reson Imaging Clin N Am 2005;13:641–52.PubMedCrossRefGoogle Scholar
  17. 17.
    Rubin DA, Paletta GA. Current concepts and controversies in meniscal imaging. Magn Reson Imaging Clin N Am 2000;8:243–70.PubMedGoogle Scholar
  18. 18.
    Bencardino JT, Beltran J, Rosenberg ZS, Rokito A, Schmahmann S, Mota J, et al. Superior labrum anterior-posterior lesions: diagnosis with MR arthrography of the shoulder. Radiology 2000;214:267–71.PubMedGoogle Scholar

Copyright information

© ISS 2007

Authors and Affiliations

  • D. G. Blankenbaker
    • 1
    Email author
  • A. A. De Smet
    • 1
  • J. S. Keene
    • 2
  • J. P. Fine
    • 3
  1. 1.Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.Department of Orthopedics and RehabilitationUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  3. 3.Department of Statistics and Department of Biostatistics and InformaticsUniversity of WisconsinMadisonUSA

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