During resisted straight leg test, pain in the anterior hip or groin indicates pathology of which structure?

• A. Hip adductors
• B. Hip flexors
• C. Gluteus maximus
• D. Quadriceps

Answer: (B)

The hip flexors are being tested. The resisted straight leg raise demands strong hip flexion with the leg kept straight, mainly engaging the iliopsoas group (and to some extent the rectus femoris). If pain is felt in the anterior hip or groin during this maneuver, it points to pathology of the hip flexors or their tendinous attachments, such as iliopsoas strain or tendinopathy. The other muscle groups are less likely: adductors cause inner-thigh pain and adduction weakness, gluteus maximus is involved in hip extension and would more likely produce posterior hip pain, and while the rectus femoris can flex the hip, groin pain during this resisted flexion most strongly implicates the hip flexors rather than the quadriceps overall.