Q1. Is it true that pelvic and hip MRI findings are associated with clinical symptoms?

A: No, unlikely.

Evidence: 39 hockey players (21 professional and 18 collegiate), who reported no symptoms related to pelvic or hip disorders, underwent MRI evaluation of the pelvic and hips. Overall, 30 of 39 (77%) asymptomatic hockey players demonstrated MRI findings of hip or groin pathologic abnormalities.

Q2. Is there concordance between hip pain and radiographic hip osteoarthritis?

A: No, unlikely

Evidence: pelvic radiographs were assessed for hip osteoarthritis in over 5,000 people in the USA. Only 10-20% of hips in those with frequent pain showed radiographic hip osteoarthritis. Most older participants with a high suspicion for clinical hip osteoarthritis did not have radiographic hip osteoarthritis.

Q3. Is acetabular labral tears a source of potential hip pain?

A: No, unlikely

Evidence: 42 hips in patients with no pain (range, 27-43 years) were assessed with MRI scans. Acetabular labral tears were identified in 36 of 42 (85.7%), suggesting that labral tears can occur without symptoms.

In addition, all the refences demonstrate that abnormalities in imaging tests (MRI, CT, X-ray, etc) are not always associated with symptoms. Rather, they are not likely to be the main source of pain in many cases.

Don't be afraid of whatever they find in these scans. Instead, try to find out what you can do for yourself.

References

Silvis, M. L., Mosher, T. J., Smetana, B. S., Chinchilli, V. M., Flemming, D. J., Walker, E. A., & Black, K. P. (2011). High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players. The American journal of sports medicine, 39(4), 715-721.

Kim, C., Nevitt, M. C., Niu, J., Clancy, M. M., Lane, N. E., Link, T. M., ... & Guermazi, A. (2015). Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study. Bmj, 351, h5983.

Weir, A., de Vos, R. J., Moen, M., Hölmich, P., & Tol, J. L. (2011). Prevalence of radiological signs of femoroacetabular impingement in patients presenting with long-standing adductor-related groin pain. British journal of sports medicine, 45(1), 6-9.

Gosvig, K. K., Jacobsen, S., Sonne-Holm, S., & Gebuhr, P. (2008). The prevalence of cam-type deformity of the hip joint: a survey of 4151 subjects of the Copenhagen Osteoarthritis Study. Acta Radiologica, 49(4), 436-441.

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.

Agricola, R., Heijboer, M. P., Roze, R. H., Reijman, M., Bierma-Zeinstra, S. M. A., Verhaar, J. A. N., ... & Waarsing, J. H. (2013). Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study (CHECK). Osteoarthritis and cartilage, 21(10), 1514-1521.

Kompel, A. J., Roemer, F. W., Murakami, A. M., Diaz, L. E., Crema, M. D., & Guermazi, A. (2019). Intra-articular corticosteroid injections in the hip and knee: Perhaps not as safe as we thought?. Radiology, 190341.