0:00

Let's move on and talk briefly about the

0:02

labrum at this point.

0:04

Obviously, as shown in this particular picture,

0:07

it is a fibro cartilaginous rim that is attached

0:11

to the edge of the acetabular.

0:14

It deepens and widens the acetabular articular surface at

0:18

the level of the hip.

0:20

It continues inferiorly here

0:23

as the transverse acetabular ligament,

0:26

and indeed the collagen fibers

0:28

that are present within the labrum are continuous with those

0:31

that are present within the transverse

0:34

acetabular uh, ligament.

0:36

There's also a ligament terries

0:38

or a ligament of the head of the femur.

0:42

Typically, we're told

0:43

that the acetabular labrum is triangular on cross-section.

0:47

That's not always the case,

0:49

but that's what the anatomy books will tell you.

0:52

It's firmly adherent shown by the orange arrows

0:56

to articular cartilage as described in most anatomy books.

1:00

We'll get back to that point in a few minutes,

1:04

and there may be a recess located away

1:08

or superficial to the labrum.

1:11

This is a paralabral recess.

1:13

It's a variable size, but pathologically may become too big

1:18

and that can be a sign of lab pathology.

1:21

And I'll show you an example of that a little bit later.

1:25

Now, we come along as the imagers

1:27

and we can do an a uhm R arthrogram,

1:30

and I'm showing you what

1:31

that looks like on a coronal fat suppressed image.

1:35

There's contrast material present within the hip joint.

1:39

Here is the constricted collar like region

1:42

around the femoral neck.

1:43

The zona orbicularis.

1:45

Here is the labrum in this case triangular

1:48

with a power label recess.

1:50

This is what it looks like histologically.

1:53

And here by the way, is the full reference to

1:55

that article if you wanna look for it.

1:58

So this is a variable size,

2:00

but located, uh, superficial to the labrum.

2:05

I wanted to show you the transverse acetabular leg, uh,

2:09

ligament, which is here.

2:11

And this is the ligament terries,

2:13

which often looks a little bit wider

2:16

and sometimes slightly higher signal where it attaches

2:20

to the femoral head.

2:22

Now, if you go ahead and do a hip arthrogram,

2:24

it's not uncommon to get contrast material that will be

2:29

deep to the fat within the acetabular fossa.

2:33

That should not be considered abnormal.

2:36

Typically, the contrast gets there by way

2:39

of the superior region, not the inferior region of the fat.

2:43

And there are examples in normal persons

2:46

where the contrast also enters into the bone.

2:49

Creating cysts like regions of the bone,

2:52

you don't wanna suggest that represents pathology.

2:56

So here then the classic hip

2:59

Gram.

3:00

Now the controversy comes in as to whether

3:03

or not there is a sub labral recess,

3:07

and if so, where does it occur?

3:09

We're gonna talk a little bit more about that

3:11

in a few minutes, but here's a picture of

3:14

what a sub labral recess might look like

3:17

in this particular case, a triangular

3:21

shaped recess separating the labrum from the

3:24

articular cartilage.

3:26

Here's my diagram, uh, of what it might look like.

3:29

Here's the sub labral recess, right?

3:32

Typically not extending all the way up to the level

3:35

of the bone, although that could vary a little bit.

3:38

Here's the triangular acetabular labrum.

3:41

These are the circumferential collagen bundles. Okay?

3:45

There is a layer of connective tissue.

3:47

Here is the power labral, uh, recess

3:50

that I spoke about earlier.

3:51

So this a sub labral recess.