Anterior Labral Tear Test (Flexion, Adduction, and Internal Rotation) FADDIR TEST

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed, Lilian Ashraf and Kim Jackson

Purpose[edit | edit source]

The FADIR test (flexion, adduction, internal, rotation) is used for the examination of Femoroacetabular impingement syndrome, anterior labral tear and iliopsoas tendinitis.[1]

The premise of this test is that flexion and adduction motions approximates the femoral head with the acetabular rim. Then internally rotating the hip places a shearing force on the labrum.[2]

This test is also called Anterior apprehension test.

Technique[edit | edit source]

Step 1. Patient is in supine position.

Step 2. Affected hip fully flexed or 90 degree flexion.

Step 3. Adduct the hip with combined Internally rotation of the hip.

Step 4. A positive test is indicated by the production of pain in the groin, the reproduction of the patient’s symptoms with or without a click, or apprehension.[2]

Pain in the groin area is considered indicative of labral pathology, including degeneration, fraying, or tearing.[2]

[3]

Evidence[edit | edit source]

For diagnosing Femoroacetabular Impingement (FAI). The sensitivity when confirmed by x-ray, MRI, or CT was 0.08 to 1, 0.33 to 1 and 0.90, respectively. The specificity when confirmed by x-ray and MRI was 0.11 and 1, respectively.[4]

Another systematic review found the FADIR test to have high sensetivity of 0.96 and low specificity of 0.11. The FADIR test along with the Foot Progression Angle Walking (FPAW) test and the maximal squat test were found to have the best sensetivities for FAI.[5]

References[edit | edit source]

  1. David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
  2. 2.0 2.1 2.2 Leibold MR, Huijbregts PA, Jensen R. Concurrent criterion-related validity of physical examination tests for hip labral lesions: a systematic review. J Man Manip Ther. 2008;16(2):E24-E41. doi:10.1179/jmt.2008.16.2.24E
  3. Vince Isaac. FADDIR Test. Available from: https://youtu.be/osQMAWOYTuo [last accessed 24/10/2022]
  4. Shanmugaraj A, Shell JR, Horner NS, Duong A, Simunovic N, Uchida S, Ayeni OR. How useful is the flexion–adduction–internal rotation test for diagnosing femoroacetabular impingement: a systematic review. Clinical Journal of Sport Medicine. 2020 Jan 1;30(1):76-82.
  5. Caliesch R, Sattelmayer M, Reichenbach S, Zwahlen M, Hilfiker R. Diagnostic accuracy of clinical tests for cam or pincer morphology in individuals with suspected FAI syndrome: a systematic review. BMJ open sport & exercise medicine. 2020 Apr 1;6(1):e000772.