Fulcrum Test for Hip Pain

Описание: The Fulcrum test is an orthopedic test to diagnose a femoral shaft fracture. It came from a paper in 1994 by Dr. Alan Johnson (Johnson, A. W., Weiss Jr, C. B., & Wheeler, D. L. (1994). Stress fractures of the femoral shaft in athletes—more common than expected: a new clinical test. The American Journal of Sports Medicine, 22(2), 248-256) where they look at several athletes that had an anterior thigh pain in which discomfort was produced when they sat on the edge of a chair with their leg dangling off. They designed this test to mimic that position and use this as an early detection of a femoral shaft stress fracture.

How to perform it:
-Patient is seated at the edge of a table
-Place your forearm under the affected thigh and place on anterior opposite thigh
-Apply a downward press on the top of the knee
-Can move your forearm forward or back to test
Positive is a production of pain symptoms

There are very few research studies on this test. In the original study, the authors found a sensitivity of 93% and 75% specificity. A later test looked specifically at female lacrosse athletes which found a sensitivity of 88% and specificity of 13% (Kang, L., Belcher, D., & Hulstyn, M. J. (2005). Stress fractures of the femoral shaft in women’s college lacrosse: a report of seven cases and a review of the literature. British Journal of Sports Medicine, 39(12), 902-906). The authors did find that with female athletes, you should be suspicious of things like a fracture and take care in your examination.

What do you think of his test? Do you use it? Should there be more research on it? Let me know down in the comments.


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