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Diagnosing labral tear or just inflamation


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Old 01-04-2017, 12:20 PM   #1
Ging482
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Diagnosing labral tear or just inflamation

My 65-year old cousin is experiencing hip pain that is making it painful to walk. She was referred to a specialist who took an MRI and diagnosed it as a tear in the acetabular labrum - tendon. She was told to do physical therapy, but it did not improve her condition. The specialist then recommended open surgery in the area that would involve making a 12-inch incision and placing an anchor in the bone that would hold the tears in the tendon together.
After researching this surgery, she felt it was a rather aggressive approach that included a long recovery time, the need to use a brace for several weeks, and further physical therapy. She now has opted for pain medication that is only minimally effective in reducing the pain. She went for a second opinion at a different specialist who looked at the MRI test results and told her she does not have a tendon tear but instead just has inflammation.
The second specialist she saw gave her a steroid injection to the hip, but she still says it goes back to the same pain within 3 days.
It seems perhaps this condition is difficult to diagnose. Does anyone else have a similar hip tendon condition that can share your diagnosis or course of treatment that was effective?

 
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Old 01-04-2017, 10:43 PM   #2
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Re: Diagnosing labral tear or just inflamation

Hi, I'm sorry your cousin is having trouble getting help for her pain. It's confusing when 2 specialists each give a different diagnosis.
Did the 2nd specialist suggest a course of steroid treatment since the injection helped for a short time?
If it is really inflammation and not a tear, maybe a longer course of steroids is needed. It is pills, not injections. I had this treatment for my back problem, and it was only a 5 or 7 day I think but it did work for my problem.
I hope she can get some relief. Please come back and post what she finds out and what works.
I am going through hip pain now after a fall and came here to find out what is working for others before I go to the doctor to get mine diagnosed.
Good luck to your cousin and it is so nice you are researching to try to help her.

 
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Old 01-05-2017, 07:27 AM   #3
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Re: Diagnosing labral tear or just inflamation

Thank you for replying. She has a follow up appointment with the 2nd specialist later this month. I'll post again after that visit. I know she is taking pain pills daily along with the injection - I think Hydrocodone. The pain pill only work for a 4-5 hours though, and she says it makes her tired and she has no appetite. I know it could be a side effect of the pain medication. I just am not entirely sure the injection is the correct route, especially if it doesn't work after 3 days? I also am also not sure being on the pain med all the time is going to giver her quality of life. If it is truly inflammation, I would think it would diminish over time but she seems to be experiencing a steady level of pain for over 6 months now with only brief hours of relief from the pain pill. She used to be quite active, but since this happened she is mostly sitting at home and is quite depressed and doesn't feel like doing this type of research that I am doing for her. Anyway - thanks for your response.

 
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Old 01-05-2017, 08:17 AM   #4
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Re: Diagnosing labral tear or just inflamation

It does sound like it may be more than inflammation then, since it has been going on this long and she should be getting some relief, not getting worse.
You are right about the injections. 3 days is not enough relief, and neither is having to take pain medication daily and putting up with the side effects of those as she then has no quality of life.
Here is what worked for me in the meantime. I had a herniation in my back, and not much helped it either, but laying in the tub daily for as long as I could keep the water real warm, took the pain away.
If she can't do that, damp heat works also. The type of gel pack you can put in the microwave for a minute or so, and put on her hip.
I don't know where you are located but I happen to be in a state where the Mayo clinic is located. If she could get to a place like this, where more than one specialist can check her MRI and any other records she already has, that is what helped me a few times, where it was a few specialists that got together and diagnosed me.
The meds she is on for pain do cause those side effects. If she is having to take them daily, along with still getting the injections, I would suggest another opinion also, as this is no way to live. Is she still getting the injections?

 
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Old 01-05-2017, 10:17 AM   #5
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Re: Diagnosing labral tear or just inflamation

She has gotten 2 injections so far, one per month. She is seeing the 2nd specialist again at the end of this month. If he only gives her the same injection that didn't work the last 2 months, I will suggest she seek a 3rd doctor as doing the same thing over and over likely will not suddenly bring about a better outcome.
We live in Michigan so the UofM hospital in Ann Arbor is the highest ranked one locally. There's also the Cleveland Clinic that is a 3 hour drive. I'll start looking for specialists at one of these facilities. This is exhausting. Thanks again for your reply.

 
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Old 01-05-2017, 10:45 AM   #6
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Re: Diagnosing labral tear or just inflamation

I know this is very wearing on a person.
I am wondering what this doctor thinks is going to change, if she has already had 2 injections, and he is letting her sit there with no relief from the pain for a month at a time?, and waiting till the end of the month to see her again? Most people would question that also, if they were not getting any better.
Just so she knows, she has all the say so in what treatment she gets, and it does sound like what she is getting is doing nothing.
She has the right to refuse another injection if the ones before gave no relief. She has the right to see a different doctor at any time and not even go back to this one.
Her symptoms sound like something was missed in the diagnosis by the 2nd doctor, because inflammation should have settled down by now. I have had inflammation and the treatment she is getting normally works.
I am wondering if she needs a specialist just to look over the MRI and x-rays again, and more tests, because it does sound like something is being missed. For example, an MRI with contrast if she didn't have one.
The first specialist may be right about the diagnosis, but the treatment offered was what scared her, and dif doctors treat problems dif ways. Maybe there is a way for it to be treated that doesn't sound so drastic.

 
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Old 01-06-2017, 09:42 AM   #7
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Re: Diagnosing labral tear or just inflamation

Good input about the contrast in the MRI. I don't think that was done. Something does sound like it is being missed with the current doctor. It was the initial treatment suggested that scared her off. I agree that if there is a less drastic treatment available that perhaps that could help. She is very confused and emotional right now. It is hard to get her focus off of just feeling bad. Thanks again. I'll keep at it.

 
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Old 01-06-2017, 10:24 AM   #8
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Re: Diagnosing labral tear or just inflamation

You bet. I don't like to see somebody suffer. I went through that for months.
I would suggest researching the specialists, and when you find one, asking for the MRI to be read and their opinion, as this dif. in diagnosis is hard for the patient to even know what to do.
Patients are always going to go the easiest route, I did too.
A doctor with many years of experience would know right away if any more tests need to be done.
The first doctor could very well be right, but I know how scary surgery sounds as I put mine off for 6 months, trying other treatments also.
It does sound like she may need surgery, but one more opinion may help.
She did not want to be laid up after the surgery for so long, but she is not able to have a life as it is right now.
I have been there, and feel for her, because the person laid up doesn't realize how they live around the pain, hoping it will get better, and months go by, and they need a relative to help them see how they don't have much of a life any more, I had that pointed out to me.

 
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Old 01-19-2017, 02:08 PM   #9
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Re: Diagnosing labral tear or just inflamation

Hi,

I have a labral tear and im 32. It was ok to begin with but after walkjng a couple of hundred yards I'd start limping and have pain around my knee too.

A great surgeon is essential. My scans were not very clear, ive had xrays, mri's and mra's. Doctors say they really need to go in to see exactly whats going on. I've also had the injections and they rarely last.

Im 32 so im getting my labrum repaired but some older people opt for THR. Thats why a recommended specialist is what you need.

Good luck

Last edited by moderator2; 01-19-2017 at 02:38 PM.

 
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Old 01-20-2017, 07:26 PM   #10
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Re: Diagnosing labral tear or just inflamation

I too have been suffering with extreme hip pain in my left hip, very painful to the touch even. And walking is the enemy, only flares it up more. I also limp badly after just a short walk. I've taken two rounds of prednisone shock packs, two rounds of cortisone injections, I use ice to relieve some of the pain, it's the only thing that helps. The prednisone took some of the swelling down but not the pain, the injections did little to nothing to help. I recently had RF Ablations on S2-L5, both left and right sides for DDD pain that just wouldn't stop, as this type of pain can spread to the hips was hoping that might help but no, well it helped my back quite a bit but not my hips. Then had injections both left and right for sciatica, also hoping it might help the hips also, but no. Also having an SI injection block for sacroiliac pain, just can't sit without pain. Maybe this will help? I'm at a loss. It just hurts so badly in my left hip. Any feedback is greatly appreciated!!!!!

 
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Old 01-20-2017, 08:11 PM   #11
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Re: Diagnosing labral tear or just inflamation

Angel,
Were any tests done on your hip? Your symptoms sound similar to bursitis. This is fluid in the hip around the joint.
The treatment for this is different than arthritis treatment. Ice, anti-inflammatory medication, rest, and sometimes aspiration of the fluid.
If no tests have been done, I would suggest asking your doctor to find the source of your hip pain so you can get the right diagnosis and treatment.
I hope you can get some relief soon! Rest and use ice until then.

 
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Old 01-21-2017, 03:08 AM   #12
only1missyf
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Re: Diagnosing labral tear or just inflamation

Angelgyrl
Have you been seeing a hip orthopefic specialist? Have you had scans carried out? Your symptoms sound very much like mine but im on crutches and now barely walk so it settles down after 2-3 weeks.

 
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hip, labral tear, surgery recovery, tendon



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