Diagnosis and Management of Hip Labral Tears

Clinical Special Tests

The FADIR test is considered the primary screening test for hip-related pain, performed by flexing the hip to 90°, adducting, and internally rotating the hip, with a sensitivity of 43% and specificity of 56% when used alone, according to the British Journal of Sports Medicine guidelines 1
No single test has perfect diagnostic accuracy; combining multiple tests improves diagnostic yield, as recommended by the British Journal of Sports Medicine 1
Clinical diagnosis should never be made on special tests alone but combined with patient symptoms and imaging findings, as suggested by the British Journal of Sports Medicine and the American College of Radiology guidelines 1, 2, 3

The American College of Radiology recommends plain radiographs of the pelvis and hip as the first imaging step if special tests suggest a labral tear, with MR arthrography being the gold standard for suspected labral tears, rated 9/9 2, 3
Alternative imaging options include high-resolution 3T MRI without contrast, which may be sufficient, as suggested by the American College of Radiology and Praxis Medical Insights guidelines 2, 3

Relying on a single special test for diagnosis can lead to inaccurate results, and diagnosis should be based on a combination of tests and clinical findings, as warned by the British Journal of Sports Medicine and Praxis Medical Insights guidelines 1, 3
Making a diagnosis based solely on imaging without correlating with clinical findings can also lead to errors, and clinicians should consider other causes of hip pain and associated conditions like femoroacetabular impingement (FAI), as cautioned by the British Journal of Sports Medicine and Praxis Medical Insights guidelines 1, 3