Fitzgerald Test: Difference between revisions

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== Technique  ==
== Technique  ==


To test for an anterior labral tear, the patient lies supine while the physical therapist (PT) performs flexion, external rotation, and full abduction of the hip, followed by extending the hip, internal rotation, and adduction. To test for a posterior labral tear, the PT performs passive extension, abduction, external rotation, from the position of full hip flexion, internal rotation, and adduction while the patient is supine. Tests are considered to be positive with pain reproduction with or without an audible click<ref name="LHJ">Leiboid M, Huijbregts P, Jensen R. Concurrent Criterion-Related Validity of Physical Examination Tests for Hip Labral Lesions: A Systematic Review. The Journal of Manual Manipulative Therapy. [online]. 2008;16(2):E24-41.</ref> <ref name="LS">Lewis CL, Sahrmann SA. Acetabular labral tears. Physical therapy. 2006 Jan 1;86(1):110-21. </ref>. The Fitzgerald test has a sensitivity of .98<ref name="LHJ" /><ref name="BRW">Burgess RM, Rushton A, Wright C, Daborn C. The validity and accuracy of clinical diagnostic tests used to detect labral pathology of the hip: A systematic review. Manual Therapy 16 (2011) 318 – 326.</ref>.    
<u>Anterior labrum</u>   


<clinicallyrelevant id="83479864" title="Fitzgerald Test - Anterior Labrum" />  
The patient lies supine while the physical therapist (PT) performs flexion, external rotation, and full abduction of the hip, followed by hip extension, internal rotation, and adduction<ref name="LHJ" /><ref name=":0">Burgess RM, Rushton A, Wright C, Daborn C. [https://rugnetwerktwente.nl/bestanden/2013/April2013/LabralTestsHip.Burgess.MT.2011.pdf The validity and accuracy of clinical diagnostic tests used to detect labral pathology of the hip: a systematic review]. Manual therapy. 2011 Aug 1;16(4):318-26.</ref>.   
 
<u>Posterior labrum</u> 
 
The patient lies supine while the PT performs passive extension, abduction and external rotation from a fully flexed, internally rotated and adducted hip<ref name="LHJ" /><ref name=":0" />.   
 
The test is considered to be positive if pain is produced with or without an audible click<ref name="LHJ">Leiboid M, Huijbregts P, 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]. The Journal of Manual Manipulative Therapy. [online]. 2008;16(2):E24-41.</ref> <ref name=":0" />.   


<clinicallyrelevant id="83479860" title="Fitzgerald Test - Posterior Labrum" />  
== Sensitivity and specificity ==
The Fitzgerald test has been shown to have a sensitivity of between 0.98 and 1.00<ref name="LHJ" /><ref name=":0" />.  The specificity is unknown<ref name="LHJ" /><ref name=":0" />. 


== Evidence  ==
<clinicallyrelevant id="83479864" title="Fitzgerald Test - Anterior Labrum" />


Sensitivity is reported to be 1.00.<ref>Fitzgerald RH., Jr Acetabular labrum tears. Diagnosis and treatment. Clin Orthop Relat Res. 1995:60-8 </ref> For inter-rater reliability of the flexion-internal rotation-adduction-impingement test, which is described like the Fitzgerald test for anterior labral tears, Kappa was 0.58 with a 95% confidence interval of (0.29–0.87).<ref>Narvani A, Tsiridis E, Kendall S, et al. . A preliminary report on prevalence of acetabular labrum tears in sports patients with groin pain. Knee Surg Sports Traumatol Arthroscop. 2003;11:403-8</ref>
<clinicallyrelevant id="83479860" title="Fitzgerald Test - Posterior Labrum" />


== References  ==
== References  ==

Revision as of 18:20, 17 May 2023

Original Editor - Rachael Lowe Top Contributors - Rachael Lowe, Wendy Snyders and Rucha Gadgil

Purpose[edit | edit source]

The Fitzgerald test utilises two different test positions to determine if the patient has an anterior or posterior labral tear.

Technique[edit | edit source]

Anterior labrum

The patient lies supine while the physical therapist (PT) performs flexion, external rotation, and full abduction of the hip, followed by hip extension, internal rotation, and adduction[1][2].

Posterior labrum

The patient lies supine while the PT performs passive extension, abduction and external rotation from a fully flexed, internally rotated and adducted hip[1][2].

The test is considered to be positive if pain is produced with or without an audible click[1] [2].

Sensitivity and specificity[edit | edit source]

The Fitzgerald test has been shown to have a sensitivity of between 0.98 and 1.00[1][2]. The specificity is unknown[1][2].

Fitzgerald Test - Anterior Labrum video provided by Clinically Relevant

Fitzgerald Test - Posterior Labrum video provided by Clinically Relevant

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Leiboid M, Huijbregts P, Jensen R. Concurrent Criterion-Related Validity of Physical Examination Tests for Hip Labral Lesions: A Systematic Review. The Journal of Manual Manipulative Therapy. [online]. 2008;16(2):E24-41.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Burgess RM, Rushton A, Wright C, Daborn C. The validity and accuracy of clinical diagnostic tests used to detect labral pathology of the hip: a systematic review. Manual therapy. 2011 Aug 1;16(4):318-26.
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