The FABER test, also known as the Patrick test, is a common orthopedic assessment tool. It is a non-invasive screening test designed to evaluate potential issues within the hip joint, sacroiliac (SI) joint, and lumbar spine. Healthcare professionals use this test to identify sources of pain and dysfunction in the lower back, buttock, and groin regions. Its simplicity and ease of performance contribute to its widespread adoption in musculoskeletal assessments.
Understanding the FABER Test
The acronym FABER stands for Flexion, Abduction, and External Rotation, describing the specific movements performed. The test aims to identify potential dysfunction or pain originating from the hip joint, sacroiliac joint, or surrounding soft tissues. It stresses various anatomical structures.
The test assesses the hip joint by applying forces, which can reveal irritation or pathology within the femoral-acetabular joint. The horizontal abduction force transfers tension through soft tissues to the sacroiliac joint, making it useful for identifying SI joint dysfunction. Structures involved include the hip joint, the sacroiliac joint that links the sacrum to the iliac bones, and muscles such as the iliopsoas and piriformis.
Performing the FABER Test
The patient lies flat on their back on an examination table. The examiner flexes the patient’s hip and knee, placing the ankle of the tested leg onto the opposite knee, creating a “figure-four” position.
Next, the examiner stabilizes the opposite side of the patient’s pelvis, typically at the anterior superior iliac spine (ASIS), to prevent compensatory movements. With the pelvis stabilized, gentle downward pressure is applied to the medial aspect of the flexed knee, moving it towards the examination table. The examiner observes the range of motion and notes any pain or discomfort reported by the patient.
Interpreting FABER Test Results
A positive FABER test result is indicated when the patient experiences pain during the maneuver or if there is a significant limitation in the range of motion compared to the unaffected side. The location of the pain helps pinpoint the potential source of the issue. For instance, pain felt in the anterior groin often suggests pathology within the hip joint, such as hip impingement, labral tears, or osteoarthritis.
Pain localized to the posterior pelvis or buttock area may indicate sacroiliac joint dysfunction or sacroiliitis. If pain is reproduced in the lumbar region, it could suggest a lumbar spine issue, as referred pain from the lumbar spine can manifest in the hip. Conversely, a negative FABER test means no pain is reproduced, and there is a full, unrestricted range of motion.
The FABER Test in Clinical Practice
In clinical settings, the FABER test serves as a screening tool, not a definitive diagnostic test. It is integrated into a comprehensive physical examination alongside other assessments to gather a complete picture of a patient’s condition. Healthcare professionals use the results to guide their clinical reasoning and differentiate between various potential sources of pain.
The test’s findings, combined with patient history and other physical examination findings, help clinicians formulate a diagnosis and determine if further diagnostic tests, such as imaging studies, are necessary. The FABER test alone may not be highly sensitive for diagnosing specific hip pathologies. It is part of a battery of assessments, and its usefulness is maximized when considered within the broader context of a patient’s symptoms and other clinical findings.