Radiology glossary

What does "labral tear" mean on your scan?

Part of: Hip findings, explained

The ring of cartilage that deepens the joint socket is torn, which can cause clicking or a feeling of looseness.

In plain English: a tear in the rim cartilage of a joint.

What it means on MRI

MRI — often with contrast dye injected into the joint (MR arthrography) for the shoulder — is the standard test for labral tears. The dye distends the joint and seeps into tear clefts, making them visible; without it, small tears are easily missed. MRI shows the tear's clock-face location, its extent, associated cartilage damage, and the paralabral cysts that often accompany tears. For hips, high-resolution non-contrast MRI can suffice, but arthrography remains the most sensitive shoulder technique.

What it means on CT

CT cannot show the labrum directly. CT arthrography (dye in the joint) can outline labral tears as contrast tracking where it should not, and is sometimes used when MRI is impossible — but it is invasive and less informative about the surrounding soft tissues. CT's real contribution is bony: the cam and pincer shapes behind hip labral tears are measured beautifully on CT.

What it means on X-ray

X-ray cannot show the labrum, but hip X-rays are essential context: they reveal the cam/pincer bone shapes that cause most hip labral tears, plus arthritis that changes everything about management. Shoulder X-rays rule out fractures and show arthritis or a Hill-Sachs dent from prior dislocation. The labrum itself, though, is invisible on X-ray.

What it means on Ultrasound

Ultrasound cannot see the labrum inside the joint, but it reliably finds the paralabral cyst — the fluid pocket that forms beside a tear — which is often the first clue. It also assesses the surrounding tendons and guides injections. A suspected labral tear still needs MRI for confirmation.

What radiologists look at next

The radiologist maps the tear on a clock face (in the shoulder, 12 o'clock is top; positions shift for hips), classifies the pattern — SLAP (top, involving the biceps anchor), Bankart (front-bottom, the dislocation tear), posterior, or degenerative fraying — and measures its extent in clock hours. They hunt for the companions: paralabral cysts (whose location points back to the tear), cartilage damage beside the tear, bone marrow edema, and in hips, the cam/pincer morphology and alpha angle that explain why the labrum failed. In shoulders they check the biceps anchor and the rotator cuff, since these injuries travel together.

Where it commonly shows up

• hip
• right hip
• left hip
• shoulder
• acetabular labrum

Questions to ask your doctor

• What treatment options exist for labral tear at the affected area?
• Where exactly is the tear, and does that location match my symptoms?
• Could this be a normal variant rather than a true tear?
• Is there cartilage damage or a cyst alongside the tear?
• For a hip tear: is there cam or pincer morphology behind it?
• Should I see a specialist, and what would they be looking for?

Common questions

What is a SLAP tear?

A tear at the top of the shoulder socket where the biceps tendon's anchor attaches — SLAP stands for the anatomic description (superior labrum, front to back). It is common in overhead athletes and after falls onto an outstretched arm. But beware: the top of the socket also hosts normal grooves that mimic SLAP tears, so the diagnosis needs clinical correlation.

What is a Bankart tear?

A tear at the front-bottom of the shoulder socket, the classic injury when the shoulder dislocates forward. It matters because it is the lesion that lets the shoulder keep dislocating — the socket's front bumper is torn off. It is usually a post-dislocation finding, not an incidental one.

Will the clicking go away on its own?

Sometimes — clicking from a small tear or variant can settle as inflammation calms, even though the structural finding persists. What matters is whether the joint feels unstable or the clicking comes with pain or catching. Painless clicking alone is rarely urgent; instability or locking deserves evaluation.

Does a labral tear always need surgery?

No. Many labral tears — especially degenerative fraying and asymptomatic variants — are managed without procedures. The tears that get a surgical conversation are usually those causing real instability, locking, or persistent pain that matches the tear's location. Your doctor and a specialist weigh the whole picture.

What each test can miss

Where MRI can mislead

MRI's great pitfall is normal variants that look exactly like tears. In the shoulder, the sublabral recess (a normal groove at the top of the socket), the sublabral foramen, and the Buford complex (a cord-like middle ligament with an absent labral segment) are classic mimics — misread, they become phantom 'tears.' In the hip, the perilabral sulcus and the stellate crease play the same trick. This is why location descriptions use clock-face precision and why MR arthrography, which shows whether dye truly enters a cleft, is the tiebreaker. A non-contrast MRI calling a subtle labral tear should be read with healthy skepticism.

Where CT can mislead

CT's pitfall is overconfidence in arthrography: dye can track into normal recesses and be misread as a tear, and CT says nothing about the cartilage and soft tissues around the labrum. Use CT for the bones behind the tear, not the tear itself.

Where X-ray can mislead

X-ray's pitfall is the invisible labrum: a normal hip or shoulder X-ray never excludes a labral tear. The subtler pitfall is missing the bony cause — cam and pincer morphology on hip X-rays is the reason most hip labral tears exist, and overlooking it misses the actual disease.

Where Ultrasound can mislead

Ultrasound's pitfall is indirectness: it finds the cyst, not the tear. A paralabral cyst strongly suggests an adjacent tear, but ultrasound cannot show the tear's size, location, or pattern — and the absence of a cyst never rules a tear out.

How radiologists tend to phrase it

The lines below are fictional illustrations of common report phrasing — not real patient reports.

SLAP tear extending from 11 o'clock to 1 o'clock with a small paralabral cyst.

A tear across the top of the shoulder socket where the biceps tendon anchors, spanning about two clock hours, with a small fluid pocket beside it. The cyst corroborates the tear — fluid leaking through the cleft.

Anterosuperior labral tear with adjacent chondral delamination.

A tear at the front-top of the socket with the nearby cartilage peeling away from the bone. The cartilage note matters because it affects the joint's future more than the labral tear alone.

Sublabral recess versus small SLAP tear — clinical correlation recommended.

The radiologist sees a cleft at the top of the socket but cannot tell a normal groove from a true tear — the single most honest sentence in shoulder MRI. 'Clinical correlation' means your symptoms and exam must break the tie.

Labral tear with cam morphology, alpha angle 62 degrees.

A hip labral tear with the bony bump (cam shape) that caused it; the alpha angle quantifies the bump. Treating the tear without noting the cam misses the underlying mechanism.

What your doctor might do next

Because normal variants mimic tears, your doctor's first job is correlation: does the tear's exact location match where you feel clicking, catching, or instability, and does the examination reproduce it? Bring a precise description — which movements cause the click, whether the joint ever feels loose or locks — because that history is what separates a real tear from an incidental variant. If the report hedges ('recess versus tear'), ask your doctor whether the finding even needs a name yet, or whether it is simply background. Hip tears with cam or pincer shapes, and shoulder tears after a dislocation, usually earn a specialist conversation; degenerative fraying found incidentally often does not. As always, the plan comes from the person examining you, not the images alone.

This is general information only — talk to your doctor about what it means for you.

Related conditions

• Joint Effusion — What It Means on Your Report
• Edema — What It Means on Your Report
• Rotator Cuff Tear — What It Means on Your Report