Purpose To assess the value of secondary signs in helping to diagnose ligamentum teres (LT) injuries. Materials and methods Seventy-nine patients enrolled in a prospective case-control study performed MRI examination of the hip joints. Two groups identified according to their clinical presentation. Group I [54 patients] with clinically suspicious LT injury, Group II [25 patients] with no clinical suspicion of such diagnosis considered as control group examining both hip joints [total 50 examined joints]. Patients of the 1st group performed sonar-guided MR arthrography. Secondary MR signs are correlated with the occurrence of LT injuries. Consensus Diagnosis employs a 5 point confidence score. Results Thirty-one cases show LT injuries in which Bone marrow edema, joint effusion, and coincidental intra-articular pathology was found in 77%, 29% and 19% of cases respectively with (p-value ≤0.001). The combined secondary signs are present in 83% of cases with LT injuries (p ≤ 0.001). The significant alteration in dimensions is in width with mean cut off 4.9 mm of injured LT with 87% specificity. Almost perfect agreement (K = 0.91, p ≤ 0.001) recorded in the consensus interpretation between the two radiologists. Conclusion The presence of the secondary signs of LT injury raises the suspicion for such diagnosis.