Patrick Test

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 Patrick Test


What is the Patrick Test?

Patrick Test assist in diagnosis of pathologies at the hip, lumbar and sacroiliac joint. It is also known as the FABER test (Flexion, ABduction, External Rotation) or figure of 4 test.

Patrick’s test was first described by Hugh Talbot Patrick, an American neurologist.

See Also: Gaenslen Test

How do you do the Patrick’s test?

Patrick test interpretation in these steps:

FABER test
FABER test

What is a positive Patrick test mean ?

Patrick Test or FABER test positive in these situations:

Sarcoiliac joint pain (chief complaint is typically posterior) on external hip rotation:

  1. Sacroiliac Joint Dysfunction.
  2. Sacroiliitis.

Posterior hip pain on external hip rotation:

  1. Posterior hip impingement.

Groin pain on external hip rotation:

  1. Intraarticular hip disorder:
    1. Hip Impingement (femoral acetabular impingement FAI).
    2. Hip Labral Tear.
    3. Hip loose bodies.
    4. Hip chondral lesion.
    5. Hip Osteoarthritis.
  2. Iliopsoas Strain or Iliopsoas Bursitis.

The Figure of 4 test (FABER test) also places the iliopsoas muscle on stretch. Pathology of the iliopsoas, such as an intrapelvic abscess irritating the iliopsoas sheath, leads to pain in this position. This is sometimes called the iliopsoas sign.

See Also: Pelvic Anatomy

Patrick’s Test Accuracy

In the various studies that have assessed the sensitivity and specificity of this test, there are a wide range of values which is likely reflective of the variety of patients used in each study and the bias that results.

A systematic review 1 of the literature for Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint, the sensitivity & specificity of Patrick test was as following:

Another study for accuracy of a clinical examination in determining intra-articular hip pain, found that the FABER test hip has a sensitivity of 60% and specificity of 18%.

Reference

  1. Kent Jason Stuber: Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc. 2007 Mar; 51(1): 30–41. PMID: 17657289.
  2. Martin RL, Irrgang JJ, Sekiya JK. The diagnostic accuracy of a clinical examination in determining intra-articular hip pain for potential hip arthroscopy candidates. Arthroscopy. 2008 Sep;24(9):1013-8. doi: 10.1016/j.arthro.2008.04.075. Epub 2008 Jun 16. PMID: 18760208.
  3. Bagwell JJ, Bauer L, Gradoz M, Grindstaff TL. THE RELIABILITY OF FABER TEST HIP RANGE OF MOTION MEASUREMENTS. Int J Sports Phys Ther. 2016 Dec;11(7):1101-1105. PMID: 27999724; PMCID: PMC5159634.
  4. Campbel’s Operative Orthopaedics 13th Edition Book
  5. Clinical Tests for the Musculoskeletal System 3rd Edition Book.
  6. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition Book.



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