A positive Adams forward flexion test for hip impingement suggests which of the following?

• A. Iliopsoas tendinopathy
• B. Osteoarthritis of the knee
• C. Sacroiliac joint dysfunction
• D. Femoroacetabular impingement or labral pathology

Answer: (D)

A positive Adams forward flexion test for hip impingement points to abnormal contact inside the hip joint during flexion, most often due to femoroacetabular impingement or labral pathology. When the hip is taken into flexion with some adduction and often internal rotation, a cam deformity on the femoral head-neck or a pincer deformity at the acetabular rim can pinch the labrum or cartilage. This contact reproduces groin pain and may produce mechanical symptoms if a labral tear is present.

This pattern of pain helps distinguish it from other possibilities. Iliopsoas tendinopathy tends to cause anterior hip or groin pain with resisted hip flexion or specific provocative maneuvers rather than a pure flexion/rotation impingement reproduction. Knee osteoarthritis involves the knee joint rather than the hip. Sacroiliac joint dysfunction usually presents with buttock or lower back pain and is provoked by pelvic and sacral maneuvers rather than a hip-directed flexion/rotation test. Thus, reproducing groin pain with hip flexion in this context points toward femoroacetabular impingement or labral pathology.