11/13/24, 7\:04 PM Guide | FABER test

FABER test

Table of contents

Background

The FABER test, also known as Patrick's test, is a pain provocation test to aid in diagnosing hip joint pathology originating from
the connective tissues. It is also used to identify a sacroiliac joint (SIJ) pathology. Additionally, it can help con
of a hip-associated pathology, such as greater trochanteric pain syndrome. The FABER test involves the following sequence of
movements\:
Flexion
ABduction
ER - external rotation
This sequence of movements is designed to stretch or compress the irritated soft tissues to reproduce the patient’s symptoms.
The FABER test is indicated when the patient complains of pain in or around the hip, groin, buttock, or SIJ. It is primarily used
to assess for\:
Femoroacetabular impingement (FAI)\: any disease process which reduces the space between the femoral head and
acetabulum may subsequently cause the sensation of pain or impingement. A disease process may be congenital (such as
CAM-type deformity or pincer-type deformity) or acquired (such as osteoarthritis, causing in
narrowing and bony spur formation).
Capsular injuries or degradation\: these are classi
(outside the joint capsule) and can involve several connective tissues. For instance, the acetabular labrum (a

excessive movements. Degenerative or in
(ROM) and increased pain sensitivity.
The FABER test can only indicate whether pathology is present. It does not tell you speci
Therefore, the FABER test should not be used as a standalone tool, and a thorough history and examination are necessary to
establish a diagnosis and the underlying cause of symptoms.
A lumbar spine assessment is also necessary since a lumbar spine pathology can cause referred hip pain. For more
information, see the geeky medics guide to hip examination and back pain history taking.

Functional anatomy

The hip joint (iliofemoral joint) is a synovial ball and socket joint formed by the articulation between the femoral head (ball) and
the acetabulum (socket). In contrast to the shoulder joint, the hip joint contains a deeper socket to provide a greater surface
area for the femoral head and e
To enhance stability, the hip joint contains several connective tissues which are susceptible to injury or degradation\:
Articular capsule\: a gel-like matrix comprised of an outer
susceptible to injury through sudden excessive movements or degradation through osteoarthritis.
Acetabular labrum\: a
may become injured through direct trauma resulting from sudden excessive movements, which are common in sports.
Ligaments\: various ligaments stabilise the femoral head, such as the iliofemoral, pubofemoral and ischiofemoral ligaments.
These may become strained through sudden excessive movements.
Bursae\: around the hip joint and its associated structures are various
contractile and non-contractile tissues. They are susceptible to bursitis resulting from overuse and in
Other connective tissues\: all anatomical structures should be considered when assessing hip pain. For example, the
tendons of various muscle groups (such as the rectus femoris and iliopsoas) may be a source of hip pain.
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Introduction

Wash your hands and don PPE if appropriate.
Introduce yourself to the patient, including your name and role.
Con
Brie
Explain the test aims to reproduce their symptoms, and they should inform you when their symptoms (e.g. pain) occur
Emphasise that you can stop the test at any time
Gain consent to proceed with the examination.
Ask the patient if they have any pain before proceeding with the clinical examination.

Perform the FABER test

The FABER test is performed on the asymptomatic side
1. Position yourself next to the side you are testing with the patient supine and the examination couch level with your hips.
2. Flex, abduct and externally rotate the patient's hip so the lateral lower leg rests on the contralateral leg above the knee.
This starting position is similar to sitting with a leg crossed (ankle-on-knee).
If you encounter resistance when trying to
chest. Alternatively, you can employ a 'popliteal unlock' by placing one hand under the crease of the knee and using two

2. Reposition your hands so that one hand is underneath the patient’s knee and the other is over the anterior superior iliac spine
(ASIS) on the contralateral side. Stabilise the ASIS during the following step; the aim is to keep the patient’s pelvis as level as
possible.
3. Instruct the patient to relax their leg and slowly release your hold underneath the knee so that it drops downwards. If this
does not reproduce the patient's symptoms, transfer the palm of your hand over the medial surface of the knee and apply
gradual downward pressure until you meet a natural resistance, taking care not to exceed the point of pain.
Watch the patient’s facial expressions and note the point at which pain is felt. The distance from the lateral femoral condyle
to the examination couch can be measured with your handspan or a tape measure if you have an assistant present.
4. Return the patient’s leg to the starting position, then walk around to the opposite side of the examination couch and repeat
the test on the symptomatic side.
5. Document your
( 2 0 c m ) f r o m e x a m i n a t i o n c o u c h"
.
" S h a r p p a i n f e l t i n h i p w i t h l a t e r a l f e m o r a l c o n d y l e a p p r o x . 1 h a n d s p a n

Interpretation of

A positive FABER test is when any pain is reproduced (this may involve pain in or around the hip, groin, buttock, SIJ, and
lumbar spine).
A negative FABER test is when pain is not reproduced.
Since pain intensity does not accurately re
Ensure to compare the a

To complete the examination...

Explain to the patient that the examination is now
Thank the patient for their time.
Dispose of PPE appropriately and wash your hands.
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Summarise your

Reviewer

Dr Richard Armitage
General Practitioner

References

1. Bagwell, J. J., Bauer, L., Gradoz, M., & Grindsta
measurements. I n t e r n a t i o n a l j o u r n a l o f s p o r t s p h y s i c a l t h e r a p y , 1 1 (7), 1101.
2. Maslowski, E., Sullivan, W., Harwood, J. F., Gonzalez, P., Kaufman, M., Vidal, A., & Akuthota, V. (2010). The diagnostic validity of hip
provocation maneuvers to detect intra-articular hip pathology. P M & R , 2 (3), 174-181.
3. Trindade, C. A., Briggs, K. K., Fagotti, L., Fukui, K., & Philippon, M. J. (2019). Positive FABER distance test is associated with higher
alpha angle in symptomatic patients. K n e e S u r g e r y , S p o r t s T r a u m a t o l o g y , A r t h r o s c o p y , 2 7 , 3158-3161.
4. Martin, R. L., Enseki, K. R., Draovitch, P., Trapuzzano, T., & Philippon, M. J. (2006). Acetabular labral tears of the hip\: examination
and diagnostic challenges. J o u r n a l o f O r t h o p a e d i c & S p o r t s P h y s i c a l T h e r a p y , 3 6 (7), 503-515.
Source\: geekymedics.com
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