Your hip MRI does NOT define you

We did it with the back(see here) and now we are…”back” with the hips.

The importance of knowing what might show up in the asymptomatic population during imaging gives us insight as to whether these findings might be relevant or not.

Imagine seeing something on an MRI that comes up with people that have no symptoms and having your treatment BASED on that given finding?

Now, imagine if that treatment was something like surgery that isn’t necessarily minimally invasive. How many surgeries are being given for things like degenerative changes at the hip, FAI aka hip impingement, or a labral tear?

So, let’s dive into some of the literature that we reference very often with the clients we work with.

Register et al.(2012) looked at 55 participants(110 hips) without any hip pain, here is what they found(1):

  • 73% of the hips they looked at displayed an abnormality of some kind(1).

  • 69% of the hips had a labral tear(1).

  • 24% of the hips had chondral defects which became more prevalent when the age >35 years old(1).

We often wonder well maybe they show up in the asymptomatic population but what if it effects our performance? Fortunately for us, they have actually looked into this. Gallo et al.(2014) looked at 21 professional hockey players without any hip or groin pain, and they followed up with them through a four year period. Here is what they found(2):

  • 15 had hip labral tears in either one or BOTH hips which accounts for 71.4%(2).

  • 8 players players had a labral tear along with a strain or tendinopathy which is 38%(2).

  • 19 of the 21 professional hockey players continued to play professional.

What about hip impingement? We got you covered again with this study from Kim et al.(2015) that looked at 473 asymptomatic adult hip joints, here is what they found(3):

  • 40% of the hips they looked at demonstrated findings that are associated with hip impingement(2).

  • The findings were more prevalent in males than females, 43.2% compared to 35.4%(2)

hockey player hip pain soho physical therapy

It’s not only these three papers above, the same results come up consistently. Schmitz et al.(2012) found that the 42 asymptomatic hips that looked at, labral tears were found in 85.7% of them(4).

Lee et al.(2015) showed that it had 38.6% prevalence in young adults(19-41), which means they are walking around with it without even knowing(5). Now imagine they start to experience hip pain because of a spike in activity or a change in lifestyle, the healthcare provider then suggests an MRI that might find a labral tear that has been there for years(5).

This is not medical advice, this is to provide you with research to inform your decisions. There are a lot of stories of people being able to live very normal lives with these findings so we have to ask ourselves, how abnormal are they?

If you’re seeking insight into your hip pain then you can schedule a free discovery call here.

We have one physical therapist on our team currently that actually has a full labral tear on the left hip who is extremely active and pain-free that will be able to provide you with guidance.

Citations:

1.) Register, B., Pennock, A. T., Ho, C. P., Strickland, C. D., Lawand, A., & Philippon, M. J. (2012). Prevalence of abnormal hip findings in asymptomatic participants. The American Journal of Sports Medicine, 40(12), 2720–2724. https://doi.org/10.1177/0363546512462124

2.) Gallo, R. A., Silvis, M. L., Smetana, B., Stuck, D., Lynch, S. A., Mosher, T. J., & Black, K. P. (2014). Asymptomatic hip/groin pathology identified on magnetic resonance imaging of professional hockey players: Outcomes and playing status at 4 Years' follow-up. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 30(10), 1222–1228. https://doi.org/10.1016/j.arthro.2014.04.100

3.) Kim, J., Choi, J.-A., Lee, E., & Lee, K. R. (2015). Prevalence of imaging features on CT thought to be associated with femoroacetabular impingement: A retrospective analysis of 473 asymptomatic adult hip joints. American Journal of Roentgenology, 205(1). https://doi.org/10.2214/ajr.14.13130

4.) Schmitz, M. R., Campbell, S. E., Fajardo, R. S., & Kadrmas, W. R. (2012). Identification of acetabular labral pathological changes in asymptomatic volunteers using optimized, noncontrast 1.5-T magnetic resonance imaging. The American Journal of Sports Medicine, 40(6), 1337–1341. https://doi.org/10.1177/0363546512439991

5.) Lee, A. J., Armour, P., Thind, D., Coates, M. H., & Kang, A. C. (2015). The prevalence of acetabular labral tears and associated pathology in a young asymptomatic population. The Bone & Joint Journal, 97-B(5), 623–627. https://doi.org/10.1302/0301-620x.97b5.35166

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Your back MRI does NOT define you