Craig's Test

Original Editor - Manisha Shrestha
Top Contributors - Manisha Shrestha, Kim Jackson and Stacy Schiurring

Purpose

Craig's test is a passive test that is used to measure femoral anteversion or forward torsion of the femoral neck.

Femoral anteversion is the degree of forward projection of the femoral neck from the frontal plane of the shaft.

There are various lower extremity alignment variables. Out of which femoral anteversion has been identified as a risk factor for hip and knee joint injury.

Increased femoral anteversion can increase hip adduction and knee abduction because the patella shifts to the medial side of the femoral condyle groove, thereby increasing the Q-angle and ultimately resulting in knee valgus deformity.

So, an accurate assessment of femoral anteversion is important for diagnosing and preventing hip and knee injuries, and Craig's test helps to measure femoral anteversion.

Technique

Patient position:

The patient was placed in the prone position with the knee flexion of 90° on an examination table.

Therapist position:

The examiner stands toward the posterolateral aspect of the tested side.

Procedure:

Examiner then palpated the greater trochanter of the tested side while passively rotating the hip until the most prominent portion of the greater trochanter reached its most lateral position.

One examiner records the value on the digital goniometer as he/she measures the femoral anteversion angle, while another examiner maintained the tibia in place.

The Femoral anteversion angle (FAA) is the angle between the shaft of the tibia and a line perpendicular to the table, is measured using a digital goniometer.

Evidence

• it decreases during the growing period. At birth, the mean angle is approximately 30°; in the adult, the mean angle is 8° to 15°. Increased anteversion leads to squinting patellae and toeing-in. Excessive anteversion is twice as common in girls as in boys. A common clinical finding of excessive anteversion is excessive medial hip rotation (more than 60°) and decreased lateral rotation in extension.

Gelberman et al. pointed out, however, that rotation should be viewed both in neutral (as in Craig’s test) and with 90° of hip flexion because rotation shows greater variability in flexion. They felt that greater medial rotation than lateral rotation in both positions was a better indicator of increased femoral anteversion. 

• Femoral internal and external rotation can be measured via the digital goniometer by 2 different methods as follows: in the supine position with 90° of hip and knee flexion and in the prone position with hip extension and 90° of knee flexion. 
• Femoral Anteversion Angle (FAA) can also be tested with help of Computer Tomographic images was defined as a crossing angle between a line drawn from the center of the femoral head to the center of the base of the femoral neck and a line connecting the exact posterior aspects of the lateral and medial condyles.  

Resources

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References

Original Editor - Manisha Shrestha Top Contributors - Manisha Shrestha, Kim Jackson and Stacy Schiurring