Positive hip FADIR and FABER tests are most consistent with which diagnosis?

• A. Hip labral tear
• B. Hip OA
• C. Femoral neck fracture
• D. Trochanteric bursitis

Answer: (B)

FADIR and FABER are provocative maneuvers that stress the hip joint to reveal intra-articular pathology. FADIR (flexion with adduction and internal rotation) compresses the anterior–superior acetabulum against the femoral head, often reproducing deep groin pain when there is joint impingement, labral disease, or other intra-articular issues. FABER (flexion, abduction, external rotation) places the femoral head against the acetabulum in a way that also stresses the joint; pain in the groin or anterior hip with this test points toward intra-articular pathology rather than pure soft-tissue or extra-articular causes.

When both tests are positive, it suggests intra-articular disease rather than an extra-articular source such as trochanteric bursitis. Among the given possibilities, osteoarthritis of the hip is the scenario most likely to yield this pattern, as degenerative changes produce joint-space narrowing and impingement that provoke pain with these motions. Labral tear can also produce positive results, but OA is more commonly associated with a pattern where both provocative maneuvers are clearly painful, especially in an older patient with degenerative changes. A femoral neck fracture presents acutely with severe pain and inability to bear weight, not a pattern best explained by these provocative tests. Trochanteric bursitis typically causes lateral hip pain and a different pain pattern rather than the deep groin pain elicited by both maneuvers.