Which imaging study is best for evaluating a suspected labral tear in the hip?

• A. X-ray
• B. CT
• C. MRI
• D. Ultrasound

Answer: (C)

When a hip labral tear is suspected, imaging needs to show soft-tissue details around the acetabulum. The labrum is fibrocartilage, so tears are best visualized with high-contrast soft-tissue imaging. X-ray and CT primarily reveal bone and alignment and don’t reliably demonstrate the labrum, while ultrasound isn’t able to visualize the intra-articular structure well. MRI provides excellent soft-tissue contrast and can clearly show labral tears, detachment, fraying, and any associated cartilage or joint-space issues. In some cases, MRI arthrography—injecting contrast into the joint to outline the labrum—offers even greater sensitivity, but MRI is the preferred initial imaging study for evaluating a suspected hip labral tear.