Table 3.

Physical examination tests for hip pain[13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29]

Test	Performance	Assessment
Leg length difference test
Galeazzi test[13,14]	Patient is supine with knees flexed at 90° and the sole of feet lie flat on the examination table. Normally both knees are at the same level.	When one knee is higher than the other, either tibia of the same side is longer or contralateral tibia is shorter. When one knee projects farther forward than the other, either that femur is longer or the contralateral femur is shorter.
Actual or functional leg length difference test[13,15]	Patient is standing with shims of varying thickness (0.5, 1, and 2 cm) placed in/under shortened leg until pelvic obliquity is fully compensated.	This will give the estimate of leg length difference. In cases where shims cannot compensate for pelvic obliquity, patient is having a fixed deformity of one or more joints leading to functional leg length difference. This can be a result of flexion or adduction contracture in hip. The pelvic dips towards normal side; the normal leg appears lengthened and effected leg shortened.
Contracture of musculature
Noble compression test[18,19,20]	Patient lies on a flat table with knee at 90° and hips at 50°. The examiner moves the knee back and forth several times from 0° to 90° while palpating the lateral epicondyle of femur on the effected site.	Palpable snapping, rubbing, crepitus or localized pain along the distal iliotibial tract (ITB) suggests a iliotibial tract frictional tendinitis. Pain in the posterior aspect of thigh indicates hamstring contracture.
Ober test[13]	Patient is in lateral position, the leg to be examined is up, slightly adducted, and hip is slightly hyperextended. The examiner places hand on distal iliotibial tract and allows leg to move from abduction to adduction.	If the leg fails to touch the floor then Iliotibial band shortening is present.
Fingertip test[14]	Patient is asked to sit on a flat table with one leg flexed at hip and knee and the other extended at hip and knee. Patient is asked to touch the toe of the extended leg with hand.	Inability to touch the toes of feet and hand in the general area of foot and complains of “pulling” pain in posterior thigh indicates hamstring contracture.
Test for hip osteoarthritis
Trendelenburg’s sign[15]	Patient in standing position is instructed to lift one leg up by flexing their hip and knee, standing on only one leg.	Positive test is 2 cm drop of the contralateral side of pelvis once the leg is lifted. Sensitivity (SN) 55%, specificity (SP) 70%
Test for Impingement/labral tear
Impingement FADIR test[25,26,27]	Supine, bilateral legs extended. Clinician passively moves the patient’s one leg to 90° hip and knee flexion. The leg is then passively adducted and internally rotated with overpressure to both motions at end range	Positive test is reproduction of concordant pain, locking, clicking and catching pain.
Thomas test[27]	Patients hold nontested leg toward their chest with bilateral arms as the clinician passively lowers the tested leg into extension. Holding the other knee to chest allows flatten lumbar lordosis and stabilizes pelvis.	If iliopsoas contracture is present then, the extended leg will not reach a full extension position on the table.
Log Roll (Freiberg) test[13,14]	Patient is in supine position with hip in a neutral position, and the leg is passively rolled into full internal and external rotation.	A click reproduced during the test is suggestive of labral tear, while increased external rotation range of movement may indicate iliofemoral ligament laxicity.
FABER test (Patrick test)[13,15]	Patient is in supine position, and one leg is extended straight on table. The other leg is flexed, adducted, and externally rotated at the hip joint. The flexed leg is pressed at knee joint.	Pain produced in groin indicates hip pain and if produced in gluteal region indicates sacroiliac pathology.
Lumbar spine radiculopathy
SLR test[11,15]	Patient is in supine, and the examiner passively elevates the leg by holding it at ankle. The hip is flexed to 70°-90° with knee extended.	Positive test is reproduction of pain in from hip to ankle in lumbosacral radiculopathy. Both SLR and cross SLR put strain on lumbosacral nerve roots. Pain restricted to posterior aspect of thigh indicates tension on hamstrings.
Miscellaneous
Piriformis test (FAIR test)[28,29]	Patient lies in lateral position with test leg uppermost.[28] The patient flexes upper hip at 60° with flexed knee. The examiner stabilizes the hip and applies downward pressure on the upper knee with internal rotation.	If sciatic nerve is pinched in pyriformis muscle than patient experiences sciatica type pain in hip and leg.[29]

FADIR: Flexion-adduction-internal rotation; SLR: Straight Leg Raise