The FABER (Flexion, Abduction, External Rotation) test is a common orthopedic assessment tool. This physical examination helps healthcare professionals evaluate potential issues within the hip joint, sacroiliac (SI) joint, and surrounding soft tissues. A positive FABER test result can provide valuable insight into underlying conditions. This article explains what a positive FABER test signifies.
Understanding the FABER Test
The FABER test, also known as Patrick’s test, is a screening tool used by healthcare professionals to assess the hip joint, sacroiliac joint, and associated structures. It primarily functions as a pain provocation test, designed to reproduce a patient’s symptoms by stressing specific areas. The acronym FABER describes the position of the leg during the test: Flexion, ABduction, and External Rotation of the hip.
During the test, a patient lies on their back while the examiner places the ankle of the leg being tested on the opposite knee, creating a “figure-four” position. The healthcare professional then applies gentle downward pressure to the knee of the tested leg while stabilizing the opposite hip. This maneuver stretches or compresses the soft tissues around the hip and SI joint, which can reveal potential dysfunction.
Interpreting a Positive Result
A positive FABER test occurs when the maneuver reproduces the patient’s pain or significantly limits the range of motion compared to the unaffected side. This indicates potential dysfunction or pathology, but it does not provide a definitive diagnosis on its own. The location of the pain elicited during the test offers important clues about the source of the problem.
Pain in the anterior hip or groin area often suggests an issue within the hip joint itself. If pain is localized to the posterior pelvis, buttock, or sacroiliac joint region, it typically points towards sacroiliac joint dysfunction or inflammation.
Common Conditions Indicated by a Positive Result
A positive FABER test can be associated with several medical conditions affecting the hip and sacroiliac joint. Hip osteoarthritis, a degenerative condition affecting joint cartilage, commonly presents with pain and stiffness during this test. Femoroacetabular impingement (FAI), where there is abnormal contact between the hip’s ball and socket, can also cause groin pain with a positive FABER test.
Labral tears, which involve damage to the cartilage rim of the hip socket, are another common finding with a positive FABER test, often presenting with groin pain. Iliopsoas muscle strain or tendinopathy, affecting the hip flexor muscles, may also cause pain in the groin area during the maneuver. Sacroiliac joint dysfunction or sacroiliitis, an inflammation of the SI joint, is frequently indicated by posterior pelvic pain during the test.
Next Steps After a Positive Result
Following a positive FABER test, further diagnostic evaluation is necessary to confirm a specific diagnosis. This often includes imaging studies, such as X-rays to assess bone structure, or Magnetic Resonance Imaging (MRI) to visualize soft tissues like cartilage, ligaments, and tendons. A CT scan might also be used for more detailed bone imaging.
A healthcare professional will also conduct a comprehensive medical history and a thorough physical examination, including other specialized tests. If systemic inflammation is suspected, blood tests may be ordered. Based on these findings, a referral to specialists like an orthopedist, rheumatologist, or physical therapist may occur. Initial management strategies could involve physical therapy, pain management techniques, or lifestyle adjustments, tailored to the suspected condition.