McCarthy test

Original Editor - Kenny Bosmans

Top Contributors - Hunter Logan, Kim Jackson, Aminat Abolade, Baile Louderback, Robert Storrow, Olajumoke Ogunleye, Kenny Bosmans, George Prudden, Wanda van Niekerk and Cindy John-Chu  

Edited April 2022 - by Hunter Logan, Baile Louderback, and Robert Storrow as part of the Arkansas Colleges of Health Education School of Physical Therapy Musculoskeletal 1 Project

Description

The McCarthy Test is a clinical test used in the diagnosis of a hip labral tear. The shearing force-producing painful popping, clicking, or catching while performing the test indicates a possible hip labrum tear.

Clinically Relevant Anatomy

Hip Joint Anatomy

The acetabulofemoral (hip) joint is the largest and most stable joint in the human body. The acetabular labrum is a soft-tissue structure which lines the acetabular rim of the hip joint.The joint is surrounded by ligaments that work to keep this articulation intact. Movements of this joint are facilitated by the articulation of the acetabulum and the labrum. In normal hip joint biomechanics, the labrum is crucial in retaining a layer of pressurised intra-articular fluid for joint lubrication and load support/distribution. Its seal around the femoral head is further regarded as contributing to hip stability through its suction effect.

Click here for more detailed information on the anatomy of the hip joint.

Technique

Step 1: The patient should be lying supine with their head supported and both arms rested to their side in a comfortable position.

Step 2: The examiner should then passively flex the affected hip to the end range.

Step 3: The clinician should then externally rotate the hip as the leg is moved back into extension.

Step 4: Repeat steps 1 and 2 but internally rotate the hip as the leg is moved back into extension.

How to do the McCarthy Hip Test for a Labral Tear - YouTube

Differential Diagnosis

Because reproduction of anterior or medial hip pain can be a positive sign for a labral pathology, it is important to realize that the McCarthy test could give a false positive for labral pathology. Other intra-articular hip disorders can present similar location of symptoms which is why further testing should be utilized.

Some of these hip pain conditions can include:

• Fractures
• Tumors
• Infection
• Osteoarthritis
• Avascular necrosis
• Adductor pathologies

Evidence

The McCarthy Test has never been accepted as the single form of diagnostic for hip pathology, which is why the clinical value remains questionable. Because of the uncertainty in the clinical value of the McCarthy Test, consistent evaluation of the patient’s subjective report is important throughout the examination. Limitations in active and passive range of motion along with arthrokinematic deviations at the hip can be presented by antalgic gait abnormalities which would be an indication that further tests should be used to rule out other possible intra-articular hip disorders.

Related Tests

• Fitzgerald Test
• FABER Test
• FADDIR Test