Hip Special Tests Flashcards
Quadrant (Scour) Test: Everything
- Indications: Pain in inner/outer quadrants of joint surface
- Perform: Pt supine. Apply pressure/compression into table & circumduct (like compression-rotation test in shoulder)
- Response: + if a restriction if felt ain the arc of motion &/or Pain is reproduced
- Implications: Capsular tightness, adhesion, myofacial restriction, or loss of joint congruity
Flexion-Add-IR Test: how to perform
Pt supine
Static test
- passive flexion & IR (end range)
Fulcrum Test: Everything
Indications: Possible femoral stress fracture
Perform: pt in dependent position. Start at distal end of femur and work proximally. Put one wrist under femur with thumb up. push toward table with other hand distal to fulcrum hand.
Response: + if reproduction of sharp pain
Implications: femoral shaft stress fractures
Anterior Labral Tear (FADDIR) Test: Everything
Implications: Pain &/or clicking over hip
Perform: pt supine. dynamic. start in figure 4 position. Push into flexion, adduction & IR before returning leg to table.
Response: + if reproduction of s/s, Pain, &/or click
Implicationis: Anterior Labral tear &/or anterior-superior FAI
Other name for Quadrant Test
Scour Test
Ober Test: Response
+ if involved knee does not cross midline
Other name for Piriformis Test
FAIR Test
Five Other Hip Tests
- Patrck’s (FABER) Test
- Fulcrum Test
- Piriformis (FAIR) Test
- Craig Test
- Quadrant (Scour) Test
Cute Chickies!
Piriformis (FAIR) Test: Everything
Implications: Possible piriformis syndrome or sciatic entrapment under piriformis
Perform: pt contralateral sidelying. Stand anterior to pt. Stablize hip. straighten tabled leg. bend top leg to 60°, hook toe under other leg. Aply pressure (IR) to knee towards floor.
Response: + if reproduction of P or s/s over intersection of priformis & sciatic nerve.
Implications: Tight and/or irritated piriformis that may be contribution to sciatic symptoms
Which tests have a + response of reproduction of s/s, pain, &/or click? (4)
The Hip Labral Tear Tests
- Flexion-Add-IR Test
- Anterior Labral Tear (FADDIR) Test
- Thomas Test
- Posterior Labral Tear Test
90/90 SLR Test: Everything
Implications: Pain over hip &/or SIJ (tests hamstring flexibility)
Perform: pt supine. Move hip to 90° flexion (pt may hold it here with hands). Passively estend knee as far as it will go and measure degrees of knee extension.
Response: + if knee doesn’t fully extend (described as > 0°). Meausre ROM and record to track progress over time.
Implications: Impaired flexibility of the hamstrings
Other name for FAIR test
Piriformis Test
Flexion-Add-IR Test: Everything
Indications: Pain &/or clicking over hip joint
Perform: pt supine. Static. Apply Flexion & IR overpressure
Response: + if reproduction of s/s, Pain, &/or click
Implications: Anterior laberal tear &/or FAI
Thomas Test: Everything
Purpose: assess anterior labrum or flexibility in hip
Indications: Pain over hip &/or SI (flex), or Pain &/or lcicking over hip.
Perform: pt in dependant position with knees off table several inches. Have pt fully flex hip and hold knee to chest. Assist pt with lying back on table.
Response: + rectus femoris, thigh on table but knee flexion < 80°; + Iliopsoas, knee flexion > 80° but thigh off table; + both if thigh off table and knee flexion is < 80°. + anterior labrum if reproduce s/s with or without click (may apply overpressure on tabled femur).
Implications: impaired flexibility of iliopsoas &/or rectus femoris. OR Anterior labral tear &/or ant-superior FAI.
Posterior Labral Tear Test: everything
Indications: Pain &/or clicking in hip
Perform: pt supine. Dynamic. Start in flexion, IR, & adduction. Move through Flexion, ER & Abduction before returning leg to table.
Respones: + if reproduction of s/s, Pain, with/without click
Implications: Posterior Labral tear &/or posterior-inferior FAI
Other name for Scour Test
Quadrant test
Ely’s Test: Everything
Indications: Pain over hip &/or SIJ (tests rectus femoris flexibilty)
Perform: pt prone. passively flex knee
Response: + if knee flexion is < 90°
Implications: impaired flexibility of Rectus Femoris
Modified Ober Test: Everything
(Like Ober Test but with knee extended)
Implications: pain over hip &/or SIJ
Perform: pt in contralateral sidelying. Stand behind pt, lift leg up & over (abduct/adduct while extending hip to end range). Stabilize pelvis on iliac crest. Allow leg to drop (be sure pelvis doesn’t move!). Note how far knee drops.
Response: + if knee does not cross midline
Implications: impaired flexibility of ITB (& TFL?)
Flexion-Add-IR Test: Implications
Anteriror Labral Tear &/or FAI
Ely’s Test: how to perform
pt prone
Passively flex knee to end range
Other name for FADDIR Test
Anterior Labral Tear Test
What tests ore indicated by pain &/or clicking over the hip joint? (4)
- Flexion-Add-IR Test
- Anterior Labral Tear (FADDIR) Test
- Thomas Test
- Posterior Labral Tear Test
Flexion-Add-IR Test: Response
+ if reproduction of pain &/or click
Other name for FABER test
Patrick’s test
Another name for the Anterior Labral Tear Test
FADDIR test
Craig Test: Everything
Indications: To assess degrees of femoral anteversion or retroversion
Perform: pt prone. Flex knee to 90°. Palpate posterior greater trochanter. Passively IR/ER hip until G. Trhoch is parallele with table (when G. Troch is most lateral), then measure IR or ER at that position with gonio.
Response: An > 8-15° in direction of IR, is considered to be anteversion (
Implications: Determines angle of femoral anteversion
Anterior Labral Tear (FADDIR) Test: How to perform
pt supine
Dynamic test
- Start in figure 4 position
- Push hip into Flexion, Adduction and IR before returning it to the table
90/90 SLR: How to perform
pt supine
Passively move hip to 90° flexion (pt may hold it there with hands). Passively extend knee. Note how far it can extend.
Response: > 0° flexion implicates reduced hamstring flexibility
90/90 SLR: Response
Response: If knee remains > 0°
Flexion-Add-IR Test: indications
Pain &/or clicking over hip joint
Five Hip Flexibility Tests
- Ober’s Test
- Modified Ober’s Test
- Thomas Test
- 90/90 SLR
- Ely’s Test
Modified Ober Test: Indications
Pain over hip &/or SIJ
(tests for ITB tightness - and maybe TFL tightness)
Indicated with hip/knee pathology
What are the advantages and disadvantages of the Ober test vs the Modified Ober Test?
The Modified Ober Test puts more tension on ITB because it is in a more lengthened position.
but
It also creates more levarage to rotate pelvis (due to the longer moment arm), so this makes it harder to stabilize the pelvis (which could confound results if the pelvis accidently moves).
Other name for Patrick’s Test
FABER Test
Three tests that implicate Anterior labral tear and/or ant-sup FAI
- Flexion-Add-IR Test
- Anterior Labral Tear (FADDIR) Test
- Thomas Test
Four Labral Tear Tests
- Flexion-Add-IR Test
- Anterior Labral Tear (FADDIR) Test
- Thomas Test
- Posterior Labral Tear Test
Patrick’s (FABER) Test: Everything
Indications: Need to differentiate between lumbar, hip, SI pathology (cannot tell what is wrong, just where)
Perform: pt supine. put in figure 4, stablize contralateral ASIS, press knee toward table. If hurts ask where.
Response: + if reproduction of s/s, pain &/or loss of motion compared to opposite side
Implications: Pain in groin suggest hip pathology; Paoin in gluteal region suggests SIJ pathology; P in lateral hip suggests hip capsule pathology.
