Patrick's / Faber / Figure Four Test

The FABER (Patrick’s) Test stands for: Flexion, Abduction and External Rotation. These three movements combined result in a clinical pain provocation test to assist in diagnosis of pathologies at the hip, lumbar and sacroiliac region.

Patrick's / Faber / Figure Four Test 

PURPOSE : The FABER test is used to identify the presence of hip pathology by attempting to reproduce pain in the hip, lumbar spine or sacroiliac region. The test is a passive screening tool for musculoskeletal pathologies, such as hip, lumbar spine, or sacroiliac joint dysfunction, or an iliopsoas spasm.
The test also assesses the hip, due to forces being transferred through the joint. The position of flexion, abduction, and external rotation, when combined with overpressure, stresses the femoral-acetabular joint and produces pain, if irritated.

TECHNIQUE : The patient is positioned in supine. The leg is placed in a figure-4 position (hip flexed and abducted with the lateral ankle resting on the contralateral thigh proximal to the knee. While stabilizing the opposite side of the pelvis at the anterior superior iliac spine, an external rotation, abduction and posterior force is then lightly applied to the ipsilateral knee until the end range of motion is achieved. A further few small-amplitude oscillations can be applied to check for pain provocation at the end range of motion. A positive test is one that reproduces the patient's pain or limits their range of movement.

INTERPRETATION : The following findings of a positive FABER test may help to guide your clinical diagnosis;

• Sarcoiliac Joint Pain on external hip rotation
• Sacroiliac Joint Dysfunction
• Sacroiliitis
• Groin Pain on external hip rotation
• Iliopsoas Strain or Iliopsoas Bursitis
• Intraarticular Hip Disorder
• Hip Impingement (femoral acetabular impingement)
• Hip Labral Tear
• Hip loose bodies
• Hip chondral lesion
• Hip Osteoarthritis
• Posterior Hip Pain on external hip rotation
• Posterior Hip Impingement

CLINICAL RELEVANCE : The FABER test can be used in assessment of the hip, sacroiliac joint or lumbar spine as a pain provocation test alongside quality subject assessment and basic objective assessment.
The FABER test is quick to perform and can give a measure of range of movement as well as being a pain provocation test, although it may not give a clear diagnosis it may assist the user in clinically reasoning which further tests or exercises to perform.