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Home› Physical Therapy› Free Self-Checks› Special Tests› Hip

Hip Special Tests

Femoroacetabular impingement, labral, osteoarthritis and muscle-length tests for the hip.

Reviewed by Dr. Richard Holsman, PT, DPT, NCS · Last reviewed November 13, 2026 · For clinician education

⚠️ For clinicians

For clinician education; special tests support but do not replace a full examination. This page is a reference for physical therapists, occupational therapists, athletic trainers, students and other clinicians. Patients with joint or spine pain should be examined by a licensed clinician.

For hip impingement and labral tears, the common tests are sensitive screening tools but not specific. For hip osteoarthritis, a five-item cluster performed well in one derivation study.

On this page

Accuracy at a glance

TestTarget conditionSnSp+LR−LRSource
FADIR testFAI / labral tear (pooled)94% to 99%———[1]
Flexion-internal rotation testFAI / labral tear (pooled)96%———[1]
Scour testHip osteoarthritis, scour with adduction causing lateral hip or groin pain62%75%2.40.51[2]
FABER testHip osteoarthritis, Patrick’s range of 60° or less (inclinometer)57%71%1.90.61[2]
Thomas testAccuracy data not verified—
Trendelenburg signAccuracy data not verified—

Sn = sensitivity, Sp = specificity, LR = likelihood ratio. A dash means the source we checked did not report that value.

How to read the accuracy numbers

  • Sensitivity: of people who have the condition, the share with a positive test. A highly sensitive test that is negative helps rule the condition out.
  • Specificity: of people without the condition, the share with a negative test. A highly specific test that is positive helps rule it in.
  • Positive likelihood ratio (+LR): how much a positive result raises the odds. About 5–10 is a moderate shift; above 10 is large.
  • Negative likelihood ratio (−LR): how much a negative result lowers the odds. About 0.1–0.2 is a moderate-to-large shift; near 1 means little change.
  • Values depend on the study’s patients, examiners and reference standard. Many studies are small, so treat single-study numbers with caution.

Hip special tests, step by step

Each test is described in our own words. Compare with the uninvolved side and stop if the test provokes severe pain.

FADIR test

Also called: Flexion-adduction-internal rotation, anterior impingement test

Purpose
Screens for femoroacetabular impingement and anterior labral pathology.
Patient position
Supine.
How to perform[3]
  1. Flex the hip to 90° with the knee bent.
  2. Adduct the hip across the body.
  3. Rotate it inward.
Positive finding
Familiar groin or anterior hip pain.

Diagnostic accuracy

Target condition (source)SensitivitySpecificity+LR−LR
FAI / labral tear (pooled)[1]94% to 99%———
Pooled specificity not given in the abstract; the authors judged it a screening test only.

Flexion-internal rotation test

Also called: FIR

Purpose
A variation of FADIR without the adduction.
Patient position
Supine.
How to perform[3]
  1. Flex the hip to 90°.
  2. Rotate it inward to end range.
Positive finding
Familiar groin pain.

Diagnostic accuracy

Target condition (source)SensitivitySpecificity+LR−LR
FAI / labral tear (pooled)[1]96%———
Screening only.

Scour test

Also called: Quadrant test

Purpose
Loads the joint surfaces and labrum through an arc of flexion and adduction.
Patient position
Supine.
How to perform[3]
  1. Flex the hip to 90° with the knee bent.
  2. Push down along the femur toward the hip.
  3. Keeping the load on, sweep the knee in an arc from abduction into adduction (add internal rotation if needed).
Positive finding
Familiar groin or lateral hip pain, or catching through the arc.

Diagnostic accuracy

Target condition (source)SensitivitySpecificity+LR−LR
Hip osteoarthritis, scour with adduction causing lateral hip or groin pain[2]62%75%2.40.51

FABER test

Also called: Patrick’s test, figure-4

Purpose
Stresses the hip (and, with overpressure, the sacroiliac joint) in flexion, abduction and external rotation.
Patient position
Supine.
How to perform[3]
  1. Place the ankle of the tested leg on the opposite knee (figure-4).
  2. Stabilize the opposite ASIS.
  3. Let the tested knee lower toward the table and apply gentle overpressure.
  4. Measure or compare knee height with the other side.
Positive finding
Groin pain (hip), back-of-pelvis pain (SIJ), or limited range compared with the other side.

Diagnostic accuracy

Target condition (source)SensitivitySpecificity+LR−LR
Hip osteoarthritis, Patrick’s range of 60° or less (inclinometer)[2]57%71%1.90.61

Thomas test

Purpose
Checks hip flexor (iliopsoas and rectus femoris) length.
Patient position
Sitting at the very end of the table, then rolled back to lying.
How to perform[3]
  1. The patient hugs one knee to the chest to flatten the low back.
  2. Let the other leg hang over the end of the table.
  3. Observe the hanging thigh and knee.
Positive finding
The thigh lifts off the table (iliopsoas), the knee straightens to less than about 80° of flexion (rectus femoris), or the thigh drifts outward (tensor fasciae latae/IT band).

Diagnostic accuracy

Accuracy data not verified. We did not find a diagnostic accuracy study for this test that we could check, so we show no numbers.

Trendelenburg sign

Purpose
Assesses hip abductor (gluteus medius) control in single-leg stance.
Patient position
Standing.
How to perform[3]
  1. Ask the patient to stand on the tested leg and lift the other foot off the floor.
  2. Hold for 30 seconds while you watch the pelvis from behind.
Positive finding
The pelvis drops on the lifted side, or the patient leans the trunk over the stance leg to stay level.

Diagnostic accuracy

Accuracy data not verified. We did not find a diagnostic accuracy study for this test that we could check, so we show no numbers.

Test clusters and prediction rules

Combinations of findings usually shift probability more than any single test.

Sutlive rule for hip osteoarthritis

Items: Five findings: squatting aggravates symptoms; active hip flexion causes lateral hip pain; scour test with adduction causes lateral hip or groin pain; active hip extension causes pain; passive hip internal rotation of 25° or less.

Accuracy: 3 of 5: sensitivity 71%, specificity 86%, +LR 5.2. 4 of 5: sensitivity 48%, specificity 98%, +LR 24.3 (95% CI 4.4–142.1), post-test probability 91%. Derivation study; not yet validated.[2]

What we left out

Log roll, resisted straight leg raise, Ober’s, Craig’s, FABER for FAI and hip lag sign: no accuracy data verified or not covered. Reiman 2015 pooled specificities and LRs are not in the abstract, so they are not shown. We only show accuracy numbers we could check against the original study or review.

Sources, review and disclosures

Graded citations

How we grade sources. A = systematic review or meta-analysis. B = single prospective diagnostic accuracy study. C = small, retrospective or case-control study, or a clinical prediction rule that has only been derived (not yet validated). D = expert clinical opinion (our test descriptions). Every accuracy number on this page was checked against the cited abstract or full text on November 13, 2026. If we could not check a number, we left it out and say “accuracy data not verified.”

  1. Grade A Reiman MP, Goode AP, Cook CE, Hölmich P, Thorborg K. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: a systematic review with meta-analysis. Br J Sports Med. 2015;49(12):811. doi:10.1136/bjsports-2014-094302 (abstract). PubMed 25515771
  2. Grade C Sutlive TG, Lopez HP, Schnitker DE, et al. Development of a clinical prediction rule for diagnosing hip osteoarthritis in individuals with unilateral hip pain. J Orthop Sports Phys Ther. 2008;38(9):542-550. doi:10.2519/jospt.2008.2753 (Tables 5 and 7; derivation study, 72 patients; reference standard: radiograph). jospt.org
  3. Grade D Holsman Physical Therapy clinical guidance. Patient position, test steps and positive findings written in our own words by Holsman physical therapists and reviewed by Dr. Richard Holsman, PT, DPT, NCS. Expert opinion, not a research source.

Reviewer

Reviewed by Dr. Richard Holsman, PT, DPT, NCS (Board-Certified Clinical Specialist in Neurologic Physical Therapy), founder of Holsman Physical Therapy. Last reviewed: November 13, 2026.

Change log

  • November 13, 2026: Page published. Test descriptions written in our own words; accuracy values checked against the cited sources.

Review policy

We re-check every number on this page against its source at least once a year, and sooner if a source is updated, a better study is published or a reader reports a problem. Changes are listed in the change log with the date. To report an error, contact us.

Licensing

Test descriptions, steps and the accuracy summaries are original text by Holsman Physical Therapy. Accuracy values are individual numbers cited with credit to the original studies; no tables, figures or text from journals, textbooks or other websites are reproduced. Linking to a source does not imply its endorsement. Demonstration videos, when added, will be filmed by Holsman physical therapists with consenting adult models.

Conflict of interest and advertising

This page is published by Holsman Physical Therapy and Wellness, P.C., which runs outpatient and in-home therapy practices; that is our only commercial interest. The page carries no advertising, no sponsorship and no affiliate links, and we received no payment from any source for it. Holsman Physical Therapy is not affiliated with the authors or publishers cited, and they do not endorse this website.

For clinician education; special tests support but do not replace a full examination. A positive or negative test changes the probability of a condition; it does not make a diagnosis. Interpret every result with the history, the rest of the examination, imaging when indicated, and clinical judgment. Stop any test that provokes severe pain or neurological symptoms.

Common Questions

Is FADIR a good test for hip impingement?

It is sensitive (pooled 94% to 99% in Reiman 2015), so a negative FADIR makes impingement or a labral tear less likely, but it is not specific and cannot confirm the diagnosis.

What is the Sutlive hip OA rule?

Five findings from a 2008 derivation study: pain with squatting, lateral hip pain with active flexion, pain with scour and adduction, pain with active extension, and internal rotation of 25 degrees or less. Four of five gave +LR 24.3.

Referring a Patient?

Holsman physical therapists see patients at clinics across North Jersey, the Bronx and Brooklyn, plus in-home visits.

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