March’s 5 minute Assessment assistant
Hip joint Intra-articular pathology or not? Ruling it out
In 2017 Reiman et al looked into ‘The diagnostic validity of hip provocation manoeuvres to detect intra-articular hip pathology.’ Examination results were compared to the same examination following Intra-Articular Anaesthetic injection- looking for an 80% decrease in pain provoked with the test.
Most Sensitive: IROP – Internal Rotation over pressure (Sensitivity of 0.91)
Next most sensitive: FABER -Flexion, Abduction, External Rotation (Sensitivity 0.82)
How To IROP:
Patient is Supine, Flex the hip/Knee to 90 degrees, Internally rotate looking for pain.
How To FABER:
Patient is Supine, Flex the Hip and Knee, Abduct, then externally rotate at the hip. The patient’s leg should now be in a figure 4 type position. Lower the knee to the bed looking for pain.
In a nutshell…
The two tests combined should take a minute, if both come up negative, the probability of an Intra-Articular pathology is minimised but not eliminated.
Hope this helps! Please feel free to give me a call any time!
Michael Rafla
Australian Sports Physiotherapy
0431 271 714
1300 651 256
[email protected]
1 Maslowski E, Sullivan W, Forster Harwood J, Gonzalez P, Kaufman M, Vidal A, Akuthota V. The diagnostic validity of hip provocation maneuvers to detect intra-articular hip pathology. American Academy of Physical Medicine and Rehabilitation’s PM&R. 2010 Mar;2(3):174- 181.1.
