Hip Assessment

ADD Test / ADD-R Test | Gluteal Tendinopathy (GTPS)

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ADD Test

ADD Test / ADD-R Test | Gluteal Tendinopathy (GTPS)

Gluteal tendinopathy which falls under the nowadays used umbrella term greater trochanteric pain syndrome or GTPS is part of the differential diagnosis in patients with lateral hip pain.

Grimaldi et al. (2016) conducted a diagnostic accuracy study on different diagnostic tests that were contrasted to MRI findings indicative of gluteal tendinopathy. The Adduction test had a sensitivity of 20% and a specificity of 86,7%. When resisted isometric abduction was added, the sensitivity rose to 38% and specificity to 93.3% The test has limited capacity to exclude the condition and it’s the first study to investigate this test which is why we give it a moderate clinical value.

To conduct the test the patient lies on the bench in diagonal side-lying position on their unaffected side with the hip and knee flexed to 80-90 degrees.

Support the affected leg with the knee extended, in neutral position so that leg is in line with the trunk. The anterior superior iliac spines are perpendicular to the treatment table. Whilst stabilizing the pelvis, the leg is moved into end-range hip adduction with overpressure. Subsequently, the patient is asked to perform isometric hip abduction against resistance. This position adds both passive and active tensile and compressive loads on the tendons of the Gluteus medius and minimus.  A positive test is the reproduction of the patient’s lateral hip pain in the region of the greater trochanter of at least 2/10 on the NPRS.

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Other  orthopedic tests that assess for gluteal tendinopathy are:

 

References

Grimaldi, A., Mellor, R., Nicolson, P., Hodges, P., Bennell, K., & Vicenzino, B. (2017). Utility of clinical tests to diagnose MRI-confirmed gluteal tendinopathy in patients presenting with lateral hip pain. British Journal of Sports Medicine, 51(6), 519-524.

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