A special test of impingement of the hip :

• Impingement of hip means in some lesions of hip pathology are impinge to some structures of hip.
• This test is applied by to doctor or therapist into a clinic to check the impingement of the hip.
• This test is applied in the clinic for the check to hip pathology.
• This test is applied when a patient is complain about hip pain.

Name of special test of impingement of the hip :

1. Anteroposterior impingement test
2. Posteroinferior impingement test

Purpose of this both impingement of the hip:

• This test is used to check for impingement of the hip.
• This test is also checked to some lesions of hip such as labral lesions , chondral lesions = anteroposterior impingement test
• This test is checked to a feeling of pain of patient such as groin pain or buttock pain = posteroinferior impingement test

Anteroposterior impingement test :

• This test is a test for hip dysplasia means acetabular retro version, slipped capital femoral epiphysis & femoroacetabular impingement.

• Technique =
• The patient lies supine with the hip flexed to 90′.
• The examiner then medially rotates & adducts the hip which leads to impingement of the femoral neck against the acetabular rim.

• Forcefully medial rotation can lead to labral lesions, chondral lesions, or both.

• Result = patient feel to pain is a positive sign.

• The hip is similarly tested in different degrees of flexion means 45′ to 120′ with pain increasing with increased flexion.

Posteroinferior impingement test :

• This test is a test for global acetabular over coverage means coxa profunda or coxa protrusion, global femoral neck offset abnormalities & posterior acetabular cartilage damage.

• This posteroinferior impingement test is positive in people who place the hip in extremes of ROM.
• People include ballet dancers, martial artists, hockey goaltenders, mountain climbers, yoga practitioners,long-striding runners.

• Technique = the patient lies supine with the legs hanging free over the edge of the bed to ensure maximum hip extensions.
• The examiner is then laterally rotates means external rotates the hip quickly.

• Result = deep-seated groin or buttock pain is an indication of posteroinferior impingement.

Modification of both test :

• DIRI = dynamic internal [medial] rotation impingement test
• DRXRIT=dynamic external[lateral]rotation impingement test
• These are modifications of the previous two tests.

• These both tests are used to commonly used in arthroscopic of the hip.

• In both tests, the patient is in supine lying.
• The examiner takes the tested hip into 90′ of flexion.

• For the DIRI test, the hip is passively moved through a wide arc of adduction & medial rotation [ internal rotation].
• While for DRXRIT, the hip is passively moved through a wide arc of abduction & lateral rotation[ external rotation].

• Result = if to patient feel the pain; it is indicated to a positive test.