Wednesday, January 23, 2008

Ligamentum Teres- Partial Tear

Wear and tear or pathologic?

That is a recurring question in orthopedic radiology.

For some reason, findings that are symptomatic in younger patients tend to clinically silent in older individuals. Part of senescence must be dead nerve endings....

Tears of the ligamentum teres of the hip can be symptomatic in younger individuals. Here is a proven partial tear of the ligamentum teres of the right hip:

The ligamentum teres is attenuated, and is imbibing contrast on this MR arthrogram.

For comparison, here is a normal ligamentum teres from the contralateral hip (I have flipped the images for clarity):

The ligamentum teres is often abnormal in the patient over the age of about 55 or 60, and this is often a bilateral finding. To my knowledge, there is no good literature on the significance of ligamentum teres pathology in the aged population.

In the younger patient though, it is certainly worth noting, as patients will respond to debridement.

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