Stephen Bird

Hi Diane,

Nice images,

I think the iliofemoral ligament is unremarkable here and there is no significant effusion.
The cystic areas are absolutely typical of para-labral cysts and this indicates there is certainly a labral tear and this can be confirmed with an MRI.

The appearance you are seeing is very common and I refer to it as a “swiss cheese” looking labrum where the labrum is expanded in size and has a herterogeneous echo texture with multiple small cystic spaces. Labral tears are common and so you can expect to see this regularly.
I label my images “anterior labrum”

In the webinar the paralabral cyst example I used was a larger cyst and hence it extends through the iliofemoral ligament and sits adjacent to the iliopsoas apparatus. This is also a common finding.

Your example is just a smaller version of the same thing.

The only confounder would be the possibility of an iliopsoas bursal effusion but if it is a mutiloculated, non compressible cystic area adjacent to the anterior labrum I would go for a paralabral cyst until proven otherwise.

The iliopsoas bursal effusions tend to be monoloculated, somewhat compressible and often larger as they commonly communicate with the hip joint.

Also remember that you can make this positive diagnosis but if a labrum looks normal on ultrasound it doesn’t exclude pathology as our sensitivity is very poor for labral tears.


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