FADDIR Test

Hip provocation maneuver

Authors
Affiliations

Doctor of Physical Therapy

B.S. in Kinesiology

Doctor of Physical Therapy

B.A. in Neuroscience

AKA
  • Flexion Adduction Internal Rotation test (FADDIR Test)
  • Anterior impingement test1

FADDIR has high sensitivity and low specificity in patients with femoroacetabular impingement syndrome (FAIS)1,2 FADDIR is also used to assess for labral pathology2.

Just as important, FADDIr can not be used to rule-in intra-articular pathologies2.

“The test has been described in both the supine and lateral recumbent position (with the affected side up). The examiner passively brings the hip into flexion, adduction, and internal rotation (Figure 4). Reproduction of pain is considered a positive test and diagnostic of FAI [16,19,20]. One study of patients with symptomatic hip pain evaluated the diagnostic accuracy of the anterior impingement test and FADDIR test, which they found to be 80%; however, their specificity was quite low at 26% and 24%, respectively [21]. Often a combination of physical exam maneuvers throughout a range of motion is the best way to dynamically stress the hip on exam to potentially reproduce the symptoms causing discomfort, and this was reflected in their same study, as the most specific maneuver was passive hip range of motion in an internally rotated and neutrally flexed hip [21]. When testing FADDIR specifically in 90° of hip flexion, this maneuver is sometimes referred to as the anterior impingement test [16,22].”1

Psychometrics

Psychometric Score
Sensitivity 59-100%1
Specificity 10-100%1
inter-rater reliability 96%1

References

1.
Wong SE, Cogan CJ, Zhang AL. Physical Examination of the Hip: Assessment of Femoroacetabular Impingement, Labral Pathology, and Microinstability. Current Reviews in Musculoskeletal Medicine. 2022;15(2):38-52. doi:10.1007/s12178-022-09745-8
2.
APTA. Current Concepts of Orthopaedic Physical Therapy. 5th ed.; 2024.

Citation

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