Patrick test: Definition, Uses, and Clinical Overview

Patrick test Introduction (What it is)

Patrick test is a hands-on physical exam maneuver used to evaluate hip and pelvic pain.
It is also widely known as the FABER test (Flexion, ABduction, External Rotation).
Clinicians commonly use it in orthopedics, sports medicine, and physical therapy.
It helps narrow down whether symptoms may relate to the hip joint or the sacroiliac region.

Why Patrick test used (Purpose / benefits)

Hip and groin pain can come from multiple structures that sit close together: the hip joint itself, the muscles and tendons around it, the sacroiliac (SI) joint, or the lower spine. Imaging is helpful, but it is not always the first step, and it may not immediately clarify the pain source—especially when symptoms are early, intermittent, or activity-related.

Patrick test is used to reproduce a patient’s familiar pain pattern in a controlled way and to stress specific joints and soft tissues. In general terms, it solves a common diagnostic problem: distinguishing “where the pain is coming from” when the location is unclear.

Common benefits in clinical practice include:

• Targeted screening: It can quickly flag whether the hip joint or SI region may be involved.
• Better exam efficiency: It is fast, low-resource, and typically performed in an outpatient exam room.
• Guiding next steps: Findings can help clinicians decide whether to emphasize hip-focused evaluation, pelvic/SI evaluation, lumbar assessment, or further testing.
• Communication tool: It gives a shared reference point for describing pain location and movement-related symptoms (for example, groin pain versus posterior pelvic pain).

Patrick test is not a diagnosis by itself. It is one data point that is interpreted alongside symptoms, function, medical history, and other examination findings.

Indications (When orthopedic clinicians use it)

Common situations where clinicians may use Patrick test include:

• Hip or groin pain that worsens with walking, pivoting, squatting, or stairs
• Buttock or posterior pelvic pain where SI joint involvement is being considered
• Reduced hip range of motion or stiffness, especially with rotation
• Suspected intra-articular hip conditions (varies by clinician and case)
• Suspected hip osteoarthritis or other degenerative joint patterns (screening level)
• Athletic groin pain evaluation, including adductor-related symptoms (as part of a broader exam)
• Pelvic girdle pain patterns, including during pregnancy or postpartum (case-dependent)
• Follow-up evaluation of previously documented hip or SI-related symptoms (to compare change over time)

Contraindications / when it’s NOT ideal

Patrick test is generally considered a low-risk exam maneuver, but it may be not suitable or less informative in certain situations. Clinicians may modify the position or choose a different assessment when:

• There is concern for an acute fracture or recent major trauma involving the hip, pelvis, or femur
• The patient has severe pain at rest or cannot tolerate gentle hip movement
• Recent hip or pelvic surgery is present and motion precautions apply (varies by procedure and surgeon)
• Advanced osteoporosis or other bone fragility concerns raise risk with positional stress
• Active infection, suspected septic arthritis, or systemic illness makes provocative testing inappropriate
• Marked hip instability or recent dislocation history is a concern (case-dependent)
• Significant mobility limitations prevent positioning (for example, severe contractures)

In some cases, another approach may be better, such as a different range-of-motion screen, neurologic assessment, or imaging—depending on the clinical context.

How it works (Mechanism / physiology)

Patrick test uses a simple biomechanical idea: by placing the hip into flexion, abduction, and external rotation, the clinician can stress or “load” structures that commonly generate hip and pelvic pain.

Key anatomy involved

• Hip joint (acetabulum and femoral head): A ball-and-socket joint where cartilage, labrum, and synovial lining can contribute to pain.
• Anterior hip and groin region: Often associated with intra-articular hip sources, hip flexor structures, and nearby soft tissues (interpretation varies by clinician and case).
• Sacroiliac (SI) joint and posterior pelvis: Located where the sacrum meets the ilium; pain here may feel deep in the buttock or posterior pelvic area.
• Adductors and surrounding soft tissues: The position can place tension across muscles and tendons of the inner thigh and anterior hip.
• Lumbar spine influence: Some hip positions can also affect low back symptoms, which is why the test is usually interpreted alongside a spine screen.

What the test is trying to provoke

During Patrick test, the examined leg is placed in a “figure-four” posture. The clinician may stabilize the opposite side of the pelvis and gently apply downward pressure on the bent knee. This combination can:

• Increase motion demand at the hip joint (especially external rotation and abduction)
• Create a lever effect through the pelvis that may stress the SI region
• Stretch or compress surrounding soft tissues depending on individual anatomy and positioning

Onset, duration, and reversibility

Patrick test is not a treatment and does not have a lasting physiologic effect by design. Any discomfort typically occurs during the maneuver and resolves when the position is released, although some people with irritable symptoms may have transient soreness. The “result” is the observed pain location, motion quality, and side-to-side comparison at that moment.

Patrick test Procedure overview (How it’s applied)

Patrick test is an examination maneuver performed by a trained clinician. Exact technique varies by clinician and setting, but the general workflow follows a familiar exam structure:

1. Evaluation/exam context – The clinician reviews symptoms (where the pain is felt, what activities trigger it, and whether there are back or neurologic features). – The test is usually one element within a broader hip and lumbopelvic assessment.

2. Preparation – The patient is typically positioned lying on their back on an exam table. – The clinician explains the maneuver and confirms the patient can tolerate hip movement.

3. Intervention/testing – The ankle of the tested leg is placed on the opposite thigh or knee area, creating a figure-four position. – The hip is gently guided into flexion, abduction, and external rotation. – The clinician may stabilize the opposite pelvis and apply gentle downward pressure to the tested knee.

4. Immediate checks – The clinician notes whether pain is reproduced, where it is felt (groin/anterior hip vs buttock/posterior pelvis vs nonspecific), and whether the movement is restricted compared with the other side. – The clinician may compare both sides for symmetry.

5. Follow-up – Findings are combined with other exam results. Depending on the overall picture, the next step may be additional physical tests, imaging, or referral—varies by clinician and case.

Because Patrick test is provocative, patient feedback about location and character of symptoms is a central part of interpretation.

Types / variations

Patrick test is commonly discussed as part of the FABER family of maneuvers, and variations exist to match patient tolerance and clinical questions. Common variations include:

• FABER vs Patrick naming

• Many clinicians use the terms interchangeably. “FABER” describes the position; “Patrick test” refers to the classic maneuver.

• Symptom-location emphasis

• Some clinicians focus on whether pain is primarily anterior/groin (often raising suspicion for hip joint involvement) versus posterior pelvic (often raising suspicion for SI region involvement). Interpretation varies by clinician and case.

• Range-of-motion–focused vs pain-provocation–focused

• The clinician may emphasize the distance the knee drops, end-feel, and asymmetry (mobility-focused) or emphasize reproduction of the patient’s typical pain (provocation-focused).

• Gentle positioning vs added overpressure

• The test may be performed with only positioning, or with gentle overpressure if tolerated. The amount of force used is clinician-dependent.

• Modified positions

• When supine positioning is difficult, clinicians may use modified hip external rotation/abduction positioning or alternative maneuvers to approximate the same biomechanical stresses.

Pros and cons

Pros:

• Quick, low-resource screening tool commonly used in clinic settings
• Can help localize symptoms to hip region versus posterior pelvis in some cases
• Offers immediate, observable findings (pain location, motion restriction, asymmetry)
• Useful as part of a standardized hip and pelvic exam sequence
• Typically does not require special equipment or imaging
• Can support clinical reasoning when combined with other tests and history

Cons:

• Not diagnostic on its own; results require context and correlation
• Pain location can be nonspecific and overlap between hip, SI, and soft tissues
• Technique and interpretation vary by clinician and case
• Limited utility if the patient cannot relax or tolerate hip positioning
• May reproduce pain from multiple sources at once, reducing clarity
• False positives/negatives can occur, especially without a comprehensive exam

Aftercare & longevity

Because Patrick test is an examination maneuver—not a treatment—there is no “aftercare” in the traditional sense. However, what happens next often depends on how the findings fit the overall clinical picture.

General factors that influence the usefulness and “staying power” of the result include:

• Symptom irritability on the day of testing: When pain is flared, many movements can provoke symptoms, which can make localization less specific.
• Consistency of symptoms: Findings are usually more informative when the test reproduces the person’s typical, familiar pain rather than a new or vague discomfort.
• Side-to-side comparison: Asymmetry in motion or pain response can be meaningful, but normal flexibility varies widely between individuals.
• Comorbid contributors: Coexisting low back problems, generalized joint hypermobility, or muscle strain patterns can alter what the test provokes.
• Follow-up examinations: Clinicians may repeat similar maneuvers over time to see whether motion and pain response change with recovery, activity modification, or rehabilitation—varies by clinician and case.

If soreness occurs after any provocative exam, it is typically short-lived and related to symptom sensitivity rather than tissue damage, but individual responses vary.

Alternatives / comparisons

Patrick test is one of several tools used to assess hip and pelvic pain. Clinicians often compare or combine it with other approaches to improve accuracy and reduce uncertainty.

Common alternatives and complements include:

• Other physical exam maneuvers
• Hip impingement-oriented maneuvers (often used to provoke anterior hip/groin symptoms)
• Hip range-of-motion measurements (internal/external rotation, flexion, extension)
• SI joint provocation test clusters (multiple tests interpreted together)

• Lumbar spine screening tests (to evaluate referred pain patterns)

• Observation and functional assessment

• Gait analysis, squat mechanics, single-leg stance tolerance, and step-down tasks can add context that a table-based test may miss.

• Imaging comparisons

• X-ray is commonly used to evaluate bony structure and degenerative changes.
• MRI may be used when soft tissues, cartilage, labrum, or bone marrow changes are suspected, depending on the scenario.
• Ultrasound may be used to evaluate certain tendons, bursae, or for guided procedures in some settings.

• Imaging selection varies by clinician and case, and imaging findings do not always match symptom severity.

• Diagnostic injections (selected cases)

• In some care pathways, image-guided anesthetic injection into a joint or region may help clarify pain source. This is not routine for everyone and depends on history, exam, and clinical goals.

Overall, Patrick test is best understood as a screening and localization tool rather than a definitive answer.

Patrick test Common questions (FAQ)

Q: Does Patrick test diagnose a specific condition?
Patrick test does not diagnose a single condition by itself. It helps clinicians understand whether pain is provoked by hip positioning that stresses the hip joint and/or the sacroiliac region. Diagnosis typically requires correlation with history, other exam findings, and sometimes imaging.

Q: What does it mean if I feel pain in the groin during Patrick test?
Groin or anterior hip pain during Patrick test may suggest involvement of structures around the hip joint, but it is not specific. Muscle, tendon, joint, and referred pain patterns can overlap in that area. Clinicians usually interpret this together with other hip range-of-motion and provocation tests.

Q: What if the pain is in the buttock or back of the pelvis?
Posterior pelvic or buttock pain during Patrick test can raise consideration of sacroiliac region involvement, among other possibilities. However, buttock pain can also be referred from the lumbar spine or come from surrounding soft tissues. The exact meaning varies by clinician and case.

Q: Is Patrick test painful?
Some people feel only a stretch, while others feel discomfort or reproduction of their typical pain. The goal is usually to identify familiar symptom patterns, not to force motion through severe pain. Clinicians can often modify positioning or pressure based on tolerance.

Q: How long do the results “last”?
The test result is an observation from that point in time—what motion looks like and what symptoms are provoked. Findings can change as pain sensitivity changes, mobility changes, or the underlying condition evolves. Clinicians may repeat the maneuver during follow-up exams to compare changes.

Q: Is Patrick test safe?
For most people, it is considered a low-risk exam maneuver when performed appropriately. It may be avoided or modified when there is recent trauma, suspected fracture, post-operative precautions, or severe pain. Safety considerations depend on individual history and clinical context.

Q: Can I drive or go back to work after the exam?
Patrick test is a brief physical exam maneuver and does not involve sedation or medication. Most people can resume normal activities immediately, but temporary soreness or symptom flare can occur in sensitive cases. Activity decisions are individualized and depend on symptom response and the broader evaluation.

Q: How much does Patrick test cost?
Patrick test is typically part of a standard clinical evaluation rather than a separately billed stand-alone service. The overall cost depends on the type of visit (primary care, physical therapy, specialist) and local billing practices. Coverage and patient responsibility vary by plan and region.

Q: What happens if Patrick test is “positive”?
A “positive” result usually means the maneuver reproduced pain and/or showed meaningful asymmetry, but what that implies depends on pain location and the rest of the exam. Clinicians may add other tests, consider imaging, or focus the evaluation on the hip, SI region, or lumbar spine. Next steps vary by clinician and case.