Patrick’s Test / Faber’s Test / Figure Four Test for Hip OA & SIJ Pain
Patrick’s Test also known as Faber’s Test or Figure Four Test is an orthopedic test in order to assess limited hip range of motion in the direction of horizontal adduction, which is commonly limited in patients with hip osteoarthritis. Ross et al. (2003) have evaluated this test’s intra-rater reliability and found a good ICC of 0.93. This means that the same tester is able to reach the same conclusion when testing a patient several times. Sutlive et al. (2008) have also evaluated its inter-rater reliability when used as a provocation test for the hip joint and found only low inter-rater reliability of k = 0.47. This means that the test has only weak clinical value as a provocation test in practice.
At the same time, Patrick’s test can be used as a pain provocation test for the sacroiliac joint. Schneider et al. (2020) evaluated this test’s accuracy regarding the diagnosis of a painful sacroiliac joint and found a sensitivity of 50% and a specificity of 56%. This means, that this test has only weak clinical value in practice.
Execution: The patient is in supine lying position and the examiner is standing on the affected side.
The patient is asked to flex the ipsilateral knee with the medial side of the heel against the other knee.
While the examiner fixates the contralateral anterior superior iliac spine (ASIS), the patient lowers the ipsilateral knee towards the treatment table as far as possible, while the plantar side of the foot remains in contact with the other knee.
At last, the examiner applies overpressure at the ipsilateral knee of 15kg for 5 seconds
This test is positive if the patient’s familiar pain (usually felt in the Fortin area/posterior joint line of the sacroiliac joint and in the groin in case of hip pain) is reproduced.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
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