Posted on Jan 31, 2020
The injury had significantly impacted her life, forcing her to put her career as a professional soccer player on hold. After two operations - labrum surgery in her right hip, followed by surgery in her left hip - she began to return to her normal activities. But just a couple months later, her symptoms resurfaced.
Desperate to figure out what was going on, Larissa requested a new hip MRI from her doctor. She wanted to ensure her scans were read by a specialist, so she reached out to DocPanel for a subspecialty second opinion.
“Larissa was worried when she came to me with her scans. Naturally, she was concerned the new hip pain could be an indication that the labrum had re-torn,” says Dr. Anthony Junck, a fellowship-trained MSK specialist. “With her career on the line, time was of utmost importance.”
Upon uploading her hip MRI scans, Larissa was also able to ask Dr. Junck specific questions she had.
“I really felt for the patient. It’s important for people to know that there is someone who understands their concerns and can answer their questions. While I was not able to see any abnormality on the scan that could be attributed to the new hip pain she was having - I was at least able to provide reassurance that the labrum was still intact,” says Dr. Junck.
Larissa’s second opinion review had some additional minor findings. In talking with the patient, Dr. Junck was able to rule out the likelihood of them being related to her pain. To be certain, he still included them in her report so that she could consult her orthopedic surgeon.
“For anyone who just went through a major operation, such as labrum surgery, it’s a really scary thought that you might have to do it all over again. On top of that, she was dealing with the stress of how this new hip pain could have further consequences on her career,” says Dr. Junck.
Larissa’s second opinion not only helped ensure her scans were accurately read, providing her peace of mind that there was not another hip labral tear, but also helped speed up the process.
Accessing subspecialty radiologists is not always easy, especially in rural areas both in the US as well as internationally. Many scans end up being read by a radiologist outside the specialty that you need - which, while sufficient for some cases, can increase the risk of misdiagnosis for others.
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Interpreting a hip MRI can be complicated given the extremely high level of detail. With more capability than ultrasound or CT, it requires a greater level of skill to read. If the interpreting radiologist is not properly trained on the nuances of what the machine can do, or is not familiar with the particular body part being examined, there’s added risk of misdiagnosis. A second opinion from a subspecialty radiologist can help prevent errors and ensure accuracy.
Even when an image was initially interpreted by a subspecialist, two reads are always better than one, explains Dr. Junck.
“It’s good for patients to have confidence in their diagnosis. If you have two reads that match or agree with one another, you can be confident that the diagnosis is being made properly. This can reduce stress and anxiety.”
When evaluating scans, patient history must also be taken into consideration. For instance, surgery or any major operation can alter a patient’s anatomy.
“With Larissa’s case, it was great that she had all her previous reports from when the hip labral tear initially happened. I could address the findings in a more specific way rather than reading the new scan blindly.”
A hip labral tear is an injury to the soft tissue that covers the socket of the hip. A hip labral tear can be caused by injury, structural problems, or degenerative issues. While some hip labral tears require surgery, others do not.
A hip labral tear diagnosis is made based on clinical evaluation and medical imaging, such as a hip MRI. X-rays can also be helpful in identifying any abnormalities of the hip bone, such as FAI (femoro acetabular impingement) or hip dysplasia.
Patients should be aware, however that hip labral tears can be easily misdiagnosed due to their overlapping similarities with other conditions of the hip. The symptoms of a hip labral tear can mimic those of hip flexor tendonitis, hip bursitis and other soft tissue injuries to the hip.
Hip MRI interpretation by a specially-trained musculoskeletal radiologist can help ensure an accurate evaluation and diagnosis. Before going forward with labrum surgery, patients can greatly benefit from a second opinion to confirm the diagnosis. And the same goes for those deciding to forgo surgery. Subspecialty review can help ensure the best course of treatment has been selected.
The name and any personal information in this article has been chnaged or annonymized to protect the privacy of the patient.