FADIR (Flexion, Adduction, Internal Rotation) Test: Difference between revisions

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=== Purpose ===
=== Purpose ===
'''The FADDIR test (flexion, adduction, internal, rotation)''' is used for examine the [[Femoroacetabular Impingement|Femoroacetabular impingement syndrome]], [https://physio-pedia.com/Labral_Tear#share anterior labral tear] and liopsoas tendinitis.<ref>David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
The FADIR test (flexion, adduction, internal, rotation) is used for the examination of [[Femoroacetabular Impingement|Femoroacetabular impingement syndrome]], [https://physio-pedia.com/Labral_Tear#share anterior labral tear] and iliopsoas tendinitis.<ref>David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
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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.<ref name=":0">Leibold MR, Huijbregts PA, Jensen R. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565117/ 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</ref>


This test is also called  '''Anterior apprehension test.'''
This test is also called  '''Anterior apprehension test.'''
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'''Step 3.''' Adduct the hip with combined Internally rotation of the hip.
'''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.
'''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.<ref name=":0" />
 
Pain in the groin area is considered indicative of labral pathology, including degeneration, fraying, or tearing.<ref name=":0" />


<div class="row"><div class="col-md-6"> {{#ev:youtube|vYfrorPzESI|300}} <div class="text-right"><ref>Special/Orthopedic Test for the Hip - FADIR (Flexion, Adduction, Internal Rotation) Test.  
<div class="row"><div class="col-md-6"> {{#ev:youtube|vYfrorPzESI|300}} <div class="text-right"><ref>Special/Orthopedic Test for the Hip - FADIR (Flexion, Adduction, Internal Rotation) Test.  
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=== Evidence ===
=== Evidence ===
FADDIR test had sensitivities ranging from 0.95 to 0.96  for the diagnosis of hip femoroacetabular impingement or labral tear.<ref>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</ref><div class="row">
 
== References ==
 
#David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
 
 
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.<ref>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.</ref>
 
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 to have the best sensetivities for FAI.<ref>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.</ref>
 
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== References ==
<references />
<references />
[[Category:Hip]]
[[Category:Hip]]

Revision as of 02:22, 24 October 2022

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed, Trista Chan, 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]

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.[5]

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 to have the best sensetivities for FAI.[6]

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. Special/Orthopedic Test for the Hip - FADIR (Flexion, Adduction, Internal Rotation) Test. Brent Brookbush. Available from: https://youtu.be/vYfrorPzES
  4. FADDIR Test. Vince Isaac. Available from: https://youtu.be/osQMAWOYTuo
  5. 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.
  6. 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.