From the Guidelines
The hip up sign, also known as the FABER test, is a clinical test used to assess for hip joint pathology, particularly femoroacetabular impingement (FAI) syndrome, acetabular dysplasia, and labral, chondral, and ligamentum teres conditions, and its significance lies in its ability to help clinicians diagnose hip-related pain in young and middle-aged active adults, as recommended by the International Hip-related Pain Research Network consensus group 1. The FABER test is performed by flexing the patient's hip to 90 degrees, then abducting and externally rotating the hip, which can help reproduce symptoms of hip-related pain.
- The test is particularly useful when combined with other clinical tests, such as the flexion-adduction-internal rotation test, to increase diagnostic accuracy.
- A comprehensive approach to diagnosis, including patient symptoms, clinical signs, and diagnostic imaging, is essential due to the limited diagnostic utility of clinical and diagnostic imaging examination in isolation 1.
- Diagnostic imaging for hip-related pain should at least include AP pelvis and a lateral femoral head-neck view radiographs, with advanced imaging recommended when further assessment of intra-articular structures or morphology is indicated 1.
- The hip up sign can help clinicians differentiate hip-related pain from other causes of hip pain, such as lumbar spine conditions, and can inform further imaging and treatment decisions 1. The most recent and highest quality study recommends a comprehensive examination of patient symptoms, clinical signs, and diagnostic imaging to diagnose hip-related pain, and the hip up sign is a useful tool in this comprehensive approach 1.
From the Research
Significance of the Hip Up Sign (FABER Test)
The hip up sign, also known as the FABER test (Flexion, Abduction, and External Rotation), is a clinical test used to assess hip joint pathology. The test is significant in medical diagnosis as it can indicate various hip-related conditions.
Clinical Relevance
- The FABER test is used to evaluate hip pain and instability, and its results can guide further diagnostic procedures and treatment plans 2.
- A positive FABER test result can suggest intra-articular hip pathology, such as labral tears or femoroacetabular impingement 2.
- The test is particularly useful in patients with chronic groin and low back pain, where hip pathology may be suspected 2.
Diagnostic Accuracy
- The FABER test has been shown to have a high sensitivity and specificity in detecting hip joint pathology, with a positive predictive value of 88% in one study 2.
- However, the test is not foolproof, and a negative result does not rule out hip pathology. Further diagnostic imaging, such as magnetic resonance arthrography or hip arthroscopy, may be necessary to confirm the diagnosis 2.
Related Conditions
- The FABER test can be used to diagnose various hip-related conditions, including sarcoglycanopathies 3, hip dysplasia 4, and neuropathies about the hip 5.
- The test can also be used to evaluate patients with risk factors for hip arthritis, such as femoral acetabular impingement, labral tearing, and developmental dysplasia 6.