The Stinchfield test is a clinical assessment used to evaluate hip pain. It helps identify potential issues within the hip joint by stressing the area. This test serves as an initial screening tool in the diagnostic process for hip-related complaints.
Identifying a Positive Stinchfield Test
The patient lies on their back (supine position) with their leg extended. They are then asked to actively lift their leg, flexing the hip to approximately 20 to 45 degrees, without bending the knee.
If this active leg raise does not reproduce pain, the examiner gently applies downward pressure on the raised thigh. The patient is instructed to resist this force. A “positive” Stinchfield test occurs when this maneuver reproduces pain in the hip or groin area, or sometimes in the thigh, buttock, or knee, especially when resistance is applied. This action increases the force across the hip joint, which can elicit pain if an underlying hip pathology is present.
Common Conditions Associated with a Positive Result
A positive Stinchfield test suggests underlying hip pathology. The test simulates forces experienced during walking, which can highlight significant hip problems. A positive result can indicate several conditions, including:
Hip arthritis, such as osteoarthritis, where joint cartilage wears down.
Avascular necrosis of the femoral head, a condition where blood flow to the bone is interrupted, leading to bone death.
Femoroacetabular impingement (FAI), a structural abnormality where hip joint bones abnormally contact each other.
Certain types of hip fractures or labral tears, which involve damage to the cartilage rim around the hip socket.
The pain arises because the maneuver increases pressure within the hip joint, stressing damaged structures or inflamed tissues.
Subsequent Diagnostic Steps
Following a positive Stinchfield test, further diagnostic evaluation is necessary to confirm a specific diagnosis. Healthcare professionals often recommend imaging studies to gain a clearer picture of the hip joint. Common techniques include X-rays, which reveal bone abnormalities or signs of arthritis, and Magnetic Resonance Imaging (MRI), which provides detailed images of soft tissues like cartilage, ligaments, and tendons.
A Computed Tomography (CT) scan can also be used for more detailed bone imaging. Alongside imaging, a comprehensive physical examination assesses range of motion, strength, and other pain-provoking movements. A thorough patient history, including symptoms, their onset, and any relevant medical background, is also gathered to provide context for the test results. These combined steps help narrow down potential causes of hip pain and guide appropriate treatment.
Interpreting Test Findings
The Stinchfield test serves as a screening tool, not a definitive diagnostic test. It suggests the likelihood of hip pathology rather than providing a conclusive diagnosis on its own. While it can help differentiate between issues originating inside (intra-articular) or outside (extra-articular) the hip joint, its diagnostic accuracy varies.
A positive result indicates a potential problem within the hip joint, but it is not specific to a single condition. False positives can occur, meaning the test indicates a problem when none exists, especially since the test’s specificity has been reported as low as 32% in some studies. Conversely, false negatives are also possible, meaning a patient with hip pathology might not experience pain during the test. Therefore, the findings of the Stinchfield test must always be interpreted within the context of a patient’s overall clinical presentation, including their symptoms, medical history, and the results of other diagnostic information.