Hip scour test: How to perform, interpret, and document findings

The hip scour test is a passive orthopedic maneuver for intra-articular hip pain. The examiner compresses the femoral head into the acetabulum and sweeps the hip from adduction to abduction. Pain, catching, crepitus, or apprehension during that arc is a positive result.

A positive finding points to a labral tear, femoroacetabular impingement (FAI), or hip osteoarthritis, and imaging is what confirms which. According to a Physical Examination of the Hip review published in PMC (NIH), the scour test helps separate intra-articular hip pain from extra-articular causes. This guide covers the technique, how to read each finding, when to withhold the test, and what to write in the note.

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Key takeaways

The hip scour test, also called the hip quadrant test, detects intra-articular hip pathology by compressing and sweeping the joint through an arc.

A positive test reproduces pain, a catching sensation, crepitus, or apprehension. None of those findings confirms a diagnosis alone, and imaging is always required.

The test has moderate sensitivity, so use it alongside the FABER and FADIR tests rather than in isolation.

Contraindications include suspected hip fracture, hip arthroplasty, severe osteoarthritis with restricted motion, and acute inflammatory arthritis.

Practice management software like Pabau gives physical therapy and sports medicine practices structured records for special test findings.

What is the hip scour test and why clinicians use it

The hip scour test is a passive examination maneuver that moves the femoral head against the acetabulum under load. The name describes the mechanics. Joint surfaces are compressed and swept in an arc, which brings out the catching, pain, or crepitus that points to structural pathology.

Clinicians reach for it when a patient reports groin pain, anterior hip pain, or deep buttock pain with a history that points at the joint. It belongs in a full hip examination alongside range-of-motion assessment and the other special tests, not as a standalone screen.

The test is also known as the hip quadrant test, and both names describe the same maneuver. “Quadrant” refers to the quadrant of hip motion being assessed, from flexion-adduction through to flexion-abduction. “Scour” is the more widely used clinical term.

How to perform the hip scour test: Step-by-step

Precise technique matters here. An inconsistent axial load or a shallow arc will not provoke intra-articular symptoms, which turns a negative result into a question mark. Follow this sequence exactly.

Patient positioning

The patient lies supine on the examination table with both lower limbs extended. The clinician passively flexes the test hip to 90 degrees and fully flexes the knee. The thigh should then sit perpendicular to the table with the lower leg hanging freely, and the other limb stays flat. Use no pillows under the lumbar spine, because the pelvis has to stay level throughout the arc.

Examiner hand placement and technique

The examiner stands on the test side and cups both hands over the patient’s flexed knee. The heel of one hand contacts the anterior knee while the other supports the leg. The examiner then applies a firm, sustained compressive force down through the long axis of the femur toward the acetabulum.

While maintaining that axial load, the examiner slowly sweeps the hip from flexion and adduction toward flexion and abduction. The arc covers roughly 30 to 40 degrees of combined adduction-to-abduction movement. Keep the speed steady and controlled rather than rapid.

• Force direction: axial, through the femoral shaft toward the hip socket, not laterally
• Arc of motion: adduction to abduction at 90 degrees of hip flexion
• Speed: slow and controlled throughout the arc
• Repeat: perform 2 to 3 passes to separate reproducible symptoms from incidental noise

What counts as a positive result

A positive hip scour test reproduces the patient’s familiar hip pain, a catching or clunking sensation, audible or palpable crepitus, or apprehension during the arc. Those symptoms have to appear under the compressive load. Discomfort from the examiner’s hand pressure alone does not count, and neither does groin pain produced by hip flexion without compression.

The distinction matters clinically. Extra-articular sources can produce discomfort during the maneuver without reproducing what the patient came in with. Hip flexor tendinopathy, iliopsoas bursitis, and referred lumbar pain all behave this way, so a hip flexor strain test helps separate them from joint pathology.

• Pain reproduction: patient’s familiar hip or groin pain reproduced during the arc
• Catching sensation: a mechanical catch or clunk felt by the examiner or reported by the patient
• Crepitus: audible or palpable grating during the arc of motion
• Apprehension: patient guarding or muscle contraction in anticipation of pain

Interpreting results: What a positive finding points to

A positive hip scour test indicates probable intra-articular hip pathology, but it does not name the structure involved. Imaging settles that question: an MRI arthrogram for labral pathology, or a plain radiograph for FAI morphology and osteoarthritic change. The result points the workup in a direction and goes no further than that.

The table below maps each type of positive finding to the pathologies it most commonly suggests, based on published orthopedic examination literature.

Diagnostic accuracy: Sensitivity and specificity

The hip scour test has moderate sensitivity for intra-articular hip pathology, and its specificity varies across published studies. The PMC review of hip physical examination (PMC9076795) reports that those values shift with operator technique, patient population, and the reference standard used. Arthroscopy, MRI arthrogram, and clinical consensus have all served as that standard, so no single accepted figure exists.

That variability is why a cluster of tests outperforms the scour test on its own. A study referenced in the PMC Physical Examination of the Hip review combined the scour test with FABER and FADIR. That cluster raised both sensitivity and specificity for labral pathology.

Key limitations clinicians should document:

• Operator variability: axial load magnitude is not standardized, which affects reproducibility between clinicians
• Specificity is lower than sensitivity, so the test produces false positives in patients with hip flexor or labral irritability from non-articular causes
• Age-related crepitus in older patients may produce positive-appearing findings without structural pathology
• The test cannot separate a labral tear from FAI, osteoarthritis, or loose bodies without imaging

How it compares to FABER, FADIR, and Stinchfield

The hip scour test sits within a battery of special tests that each probe different intra-articular and peri-articular structures, and no single one is sufficient. The FADIR test is generally regarded as the most sensitive for FAI and labral pathology. The FABER test, also called the Patrick test, probes the sacroiliac joint as well as the hip. The Stinchfield test isolates the iliopsoas and anterior hip under resisted flexion load.

The scour test contributes the axial load combined with the arc, so it stresses the whole quadrant of the joint surface rather than one position. That makes it complementary to the FADIR, which targets anterior impingement specifically, and useful where the clinical picture is ambiguous.

Patients who describe an audible click or a snapping sensation with hip movement need a different provocation sequence. Our guide to the snapping hip test sets out the Ober, FABER, and FADIR maneuvers used for that presentation.

When to use the test in a hip examination

The hip scour test is indicated when a patient presents with deep groin or anterior hip pain that may have an intra-articular origin. It fits into the special tests phase of the examination, after observation, palpation, and active and passive range-of-motion testing.

At that point, a positive scour test adds meaningful weight to the probability of intra-articular pathology and justifies a referral for imaging.

It is most useful for patients in the following presentations:

• Young to middle-aged active adults with deep groin pain and possible FAI morphology
• Athletes with anterior hip pain following repetitive hip flexion loading (runners, cyclists, footballers)
• Patients with suspected labral pathology based on a history of click, catch, or giving way
• Older adults with groin pain where hip OA is being separated from lumbar-referred pain

Contraindications and precautions

Most clinical references describe the technique without saying when to skip it. That omission matters, because axial compressive force across a compromised hip can cause harm. The following are absolute or relative contraindications to the hip scour test.

• Suspected or confirmed hip fracture: axial loading is absolutely contraindicated until fracture is excluded by imaging
• Hip arthroplasty (total or partial): the maneuver risks dislocation or mechanical failure of the prosthesis
• Severe osteoarthritis with markedly restricted range of motion: forcing the arc causes pain and injury without adding diagnostic value
• Acute inflammatory arthritis (active flare): compressive loading during acute synovitis provokes pain non-specifically and may worsen the flare
• Acute pelvic or acetabular fracture: as with hip fracture, axial load is contraindicated

Screening for those five takes seconds, and it changes what happens next. The panel below sets the two pathways side by side.

Where a contraindication is present, rely on non-compressive tests such as passive range of motion and the log roll test, then refer directly for imaging.

How to document the findings in the clinical note

Special test findings tend to be recorded differently by every clinician on a team. When one physical therapist performs the test and a colleague reads the note two weeks later, the wording decides how much survives. An entry that says only “scour test positive” carries almost nothing. A complete record of the finding includes the following elements.

• Side tested: left or right hip, clearly stated
• Nature of positive finding: pain, catching, crepitus, or apprehension, plus the location (anterior groin, lateral hip, deep buttock)
• Degree of flexion at onset: where in the arc symptoms were provoked (early adduction, mid-arc, late abduction)
• Severity: VAS or NRS score for the reproduced pain
• Action taken: whether imaging was ordered, the referral pathway, and any change to the treatment plan

Consistency matters most in multi-practitioner physical therapy and sports medicine practices, where several clinicians assess the same patient across a course of treatment. Serial comparison gets easier when every assessment lands in one client record, which is what software for physical therapists is designed to do.

A shared examination template is what keeps those data points identical from one visit to the next. Our guide to physiotherapy practice management software covers how teams set those templates up and keep them in use.

How Pabau keeps hip examination findings consistent across your team

Most practices still record special test findings in free text, so the level of detail depends on who is typing. The side tested, the point in the arc, and the severity score each get written differently across a team, and serial comparison suffers for it.

Practice management software like Pabau replaces that free text with a structured hip examination form. Every clinician completes the same fields, so a scour test result reads the same way whoever performed it. The finding sits in the client record next to the appointment, the treatment plan, and the referral letter.

Pabau Scribe, our AI scribe, transcribes dictated notes straight from the examination room. The examiner can speak the scour test finding aloud and move on to the next patient, rather than typing it up between appointments. High-volume musculoskeletal practices get that documentation time back without losing detail from the note.

Document hip examination findings faster with Pabau

Pabau helps physical therapy and sports medicine practices record special test results, clinical notes, and follow-up plans in structured, searchable client records. Book a demo to see how it works.

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Conclusion

The hip scour test earns its place when it is performed with a consistent axial load and read alongside FABER and FADIR. On its own it narrows the possibilities without closing them, and imaging still decides the diagnosis.

Two habits do more for the patient than any refinement of technique. Screen for the five contraindications before you load the joint. Then write the finding down in enough detail that the next clinician can act on it without repeating the examination.

Structured records make that second habit automatic rather than a matter of individual discipline. Book a demo to see how Pabau keeps hip examination findings consistent across every clinician on your team.

Continue your research

Opening or running a physical therapy practice? Opening a physiotherapy clinic covers the operational and compliance steps for establishing a practice, including documentation systems and client record requirements.

Need a wider screen before the special tests? Hip mobility test walks through the range-of-motion self-assessments that sit before provocation testing in a hip workup.

Suspect a labral tear after a positive scour test? Labral tear test sets out the provocation sequence and gives you a recording form for the findings.

Planning the rehab phase once imaging is back? Return-to-running protocol shows how assessment findings translate into a staged loading plan for active patients.

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