Right hip pain in a 20-year-old epee fencer

FormalPara Part I

A 20-year-old woman presented with 3 months of hip pain. She is on the Olympic developmental squad for epee fencing and states that the pain involves the leading leg when she lunges. She has full range of motion but positive impingement signs on physical exam. AP, frog lateral and cross table lateral views of the right hip as well as indirect MR arthrography (iMRA) of the left hip were obtained (Fig. 1).

Fig. 1

Axial oblique (a) and sagittal (b) fat-suppressed PD iMRA, and proton density–weighted radial (c) image through the 10:30 position of the anterosuperior labrum. Depressed cortical impaction (open arrow) with marrow edema (dotted arrow) along the anterior femoral head-neck junction and relative thickening of the subjacent neck cortex (thin white arrow) are seen in a and b. Amputated tear of the anterior superior labrum (thick white arrow) opposite the notch on sagittal (b) image and radial image (c). The tear extended from 10 – 11:00. d Cross table lateral radiograph of right hip. Both the impaction injury (open arrow) and reactive cortical thickening (thin white arrow) are seen on plain radiograph. The patient did not have radiographic cam or pincer deformity