The Supine Labrum/Impingement Test (axial compression with internal rotation) primarily assesses which hip pathology?

• A. Hip impingement due to labral pathology
• B. Iliopsoas tendinopathy
• C. Hip fracture
• D. Snapping hip syndrome

Answer: (A)

The test is aimed at loading the hip joint to stress the acetabular labrum and any contact that occurs with the femoral head, which is what happens in labral tears and femoroacetabular impingement. By applying axial compression through the leg while the hip is in internal rotation, the joint surfaces are pressed together and the labrum is irritated. If this reproduces groin pain, or a concordant clicking or catching is felt, it suggests pathology of the labrum or impingement due to abnormal coupling of the femur and acetabulum.

This isn’t a test for iliopsoas tendinopathy, which is usually probed with resisted hip flexion or palpation over the iliopsoas tendon. It isn’t a test for a hip fracture, which presents with acute trauma and distinct tenderness and functional inability to bear weight. And it isn’t a test for snapping hip syndrome, which is identified by dynamic movement-related snapping from the iliopsoas or IT band over bony structures during flexion, extension, or rotation rather than by this joint-loading maneuver.