Hip labral tears as a co-morbidity of low back and pelvic girdle pain following motor vehicle collisions: A case series

Abstract

The failure of some cases of low back and pelvic girdle pain to progress following a motor vehicle collision (MVC) prompted the search for other sources of pain. The literature reports acetabular labral (AL) tears from all causes are under diagnosed. Our search found mention of 2 cases of posterior labral tears caused by the knee impacting the dash board in MVCs but we found no other articles that associated AL tears (particularly anterior tears) to MVCs. Failure to recognize and address the pathology may predispose the hip to degenerative changes over time.

This report documents 16 cases with a total of 21 hips with AL tears or labral pathology coupled with chronic low back and pelvic girdle pain following MVCs. Diagnosis was made with a combination of hip blocks and MRI/arthrogram (MRA). The most common clinical features are deep buttock and anterior groin pain, clicking, locking and a positive impingement test.

Clinicians need to have a high index of suspicion of labral pathology in MVC cases with low back, buttock, groin and posterior pelvic girdle pain that fail to resolve with time and conservative treatment directed at the low back and pelvic girdle.