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Failure to perform an effective physical exam is one of the most inefficient processes within a chiropractic office. Evidence-based clinicians must utilize only the most sensitive and specific tests to ensure a proper diagnosis, clinical success, and resultant patient satisfaction. Today, let’s take a deep dive into the FABER test to understand how chiropractors can use it for diagnostic accuracy and patient education.

Watch this video to see how Dr. Steele merges experience with research in performing the FABER Test.

What is FABER Test?

The supine patient’s hip is flexed, abducted, and externally rotated into a figure four position. The clinician stabilizes the opposite ASIS and applies a pulsating downward force to the knee. FABER test is a generalized screening test routinely positive (88%) for most hip pathology.

So, you perform the test and it changes the patient’s symptoms.  Symptom response and location provide vital clues to the origin of tissue pathology.

Increased Groin Pain

FABER Test may elicit groin pain from an impingement of the affected hip. A sudden or sharp pain indicates a positive result. However, FABER Test has high sensitivity, specificity, and positive predictive value for identifying labral pathology OR intra-articular causes of pain. Definitive diagnosis requires further evaluation, patient demographics, imaging, and physical activity questioning. For example, older individuals are at an increased risk for osteoarthritis. Furthermore, patients with an increased BMI and a sedentary lifestyle are also at risk for degenerative, intra-articular, hip conditions. (1) However, younger individuals participating in sports involving repetitive hip flexion and rotation would be suspect to labral pathology.

Decreased Groin Pain

A decrease in inguinal pain indicates the possibility of femoral acetabular impingement (FAI). Most patients presenting with groin pain that are young and physically active with unilateral hip pain suffer from FAI. Presenting complaints typically include insidious onset, anterior hip or groin pain. The pain is generally dull and achy. While the FABER test is a generalized screening test that is routinely positive for most causes of hip pathology, it is often negative in cases of bony impingement of the hip. (2) If groin pain decreases with FABER Test, consider following up with FADIR Test to confirm impingement.

Increased Posterior Buttock/Sacral Pain

The FABER Test also has a high specificity and positive predictive value for the diagnosis of sacroiliac dysfunction.  In combination with the Thigh Thrust Test, the improved overall diagnostic ability is second to none according to a recent study by Nejati et al. (2020)

Thigh Thrust

Orthopedic testing is never 1 to 1 for a specific diagnosis. However, the utilization of sensitive/specific tests combined with subjective symptoms will lead you and your patient down a path of success. Consider using the condition reference sections within ChiroUp to enhance your diagnostic skill for every condition. Then prescribe the most appropriate condition report to improve your patient’s understanding of their condition.

Applying the right clinical knowledge & then empowering your patients with the right tools to aid in their recovery is the difference between “good” care and “exceptional” care. 

How are you planning on using ChiroUp to meet your 2021 goals? Comment your plan in the comment section below, and let’s start a conversation. I want to hear from you!

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References
  1. Kontio T, Heliövaara M, Viikari-Juntura E, Solovieva S. To what extent is severe osteoarthritis preventable? Occupational and non-occupational risk factors for knee and hip osteoarthritis. Rheumatology. 2020 Jun 13. Link
  2. Tijssen M, van Cingel R, Willemsen L, de Visser E. Diagnostics of femoroacetabular impingement and labral pathology of the hip: a systematic review of the accuracy and validity of physical tests. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2012 Jun 1;28(6):860-71. Link
  3. Nejati P, Sartaj E, Imani F, Moeineddin R, Nejati L, Safavi M. Accuracy of the Diagnostic Tests of Sacroiliac Joint Dysfunction. Journal of Chiropractic Medicine. 2020 Mar 1;19(1):28-37. Link

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