Table 2.

Physical exam maneuvers to aid in the diagnosis of hip instability

Maneuver	Steps to perform	Positive findings
Intra-operative axial stress exam under anesthesia	Axial traction is applied to the operative hip; may be repeated on non-operative hip for comparison.	- Easily distracted hip - Joint space widening relative to the contralateral hip observed fluoroscopically
Axial distraction test	Supine; flex hip to 45° and knee to 90°; stabilize patient’s pelvis by placing knee on ischium and apply axial force through hip.	- Patient-reported pain - Apprehension - Toggle - Asymmetry of hips
Dial test	Supine; hip is passively internally rotated and released while observing for degree of passive external rotation; repeated on contralateral lower extremity	- Increased external rotation compared to contralateral lower extremity - Soft endpoint with external rotation
Abduction-extension-external rotation test	Lateral decubitus with affected hip up; hip abducted to ~30°, extended, externally rotated, and an anteriorly directed force is applied to the greater trochanter	- Anterior hip pain - Apprehension
Anterior apprehension (hyperextension, external rotation) test	Supine; flex contralateral hip to 90° with adduction and internal rotation, flexed towards chest and hip of interest is hyperextended and externally rotated	- Patient-reported pain - Apprehension