Craig’s Test

If you have a patient that has trouble walking, then administer the Craig’s Test to gauge their femurs for any signs of high femoral anteversion or retroversion and see if they are at risk of developing one or if it’s a sign of other complications they might have or are developing.

By Matt Olivares on Apr 08, 2024.

Fact Checked by RJ Gumban.

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What is the Craig’s Test?

is a type of physical examination developed to assess the degree of anteversion (the internal rotation) in the femur. Since the femur is the bone that connects a knee to a hip, the positioning of the femur is important because its positioning may affect the alignment and movement of the entire leg. As such, this particular assessment is one way to examine the femur’s rotation and if the patient is at risk of developing or is showing signs of having physical problems like hip impingement, pigeon-toed walking, patellofemoral pain syndrome, and femoral torsion syndrome.

The test also measures femoral retroversion (the external/outward rotation) in the femur. If there is an increased retroversion in the femur, it can also point to problems such as out-toeing, hip dislocation, and even hip dysplasia.

Administering the Craig’s Test is a time-efficient way of gauging a person for possible femoral problems. The results of this particular test will serve as valuable information when it comes to confirming if a person is suffering from femoral/hip problems as well as what can be done in order to manage these problems or, if it’s possible, rehabilitate and fix the femurs.

Check out this video to see how the Craig's Test is performed:

Printable Craig’s Test

Download Craig’s Test to assess patients for signs of high femoral anteversion or retroversion.

How to conduct the Craig’s Test

Before you conduct the Craig’s Test, there are two things that you need to make sure are present in the testing space. The first thing that you need is a flat surface. If you have an examination table, that works, too. The second thing that you need is a goniometer.

The first thing that you have to do is to instruct your patient to lie down on a flat surface in a prone position (face down), then have them flex one of their knees (whichever side you are testing) by 90 degrees.

As for you, you need to position yourself on whichever side you are testing. Once you are in position, you will do the following:

  • You must palpate the greater trochanter
  • Then you must rotate their hip medially and laterally while palpating the greater trochanter
  • You will do this until the greater trochanter lies at the most lateral part of the hip. If you want to know if the greater trochanter is already lying there, you just need to check if the greater trochanter is parallel to the examination table or bed. Once it is at the most lateral part of the hip, the femoral head should be projecting into the center of the acetabulum.
  • After that, you just need to measure the angles of both the medial and lateral rotations using your goniometer.

How to interpret the results of the Craig’s Test:

Once you have already conducted the tests for both femurs and measured both the medial and lateral rotations of each leg, write down the measurements. We created a template for the Craig’s Test, which you will see later on in this guide.

Now, in order to interpret the results, you may refer to the following designations:

  • Normal - the mean anteversion for adults is 8 to 15 degrees (angle of internal rotation)
  • Increased Anteversion - this is the result if the angle of rotation is greater than 15 degrees. This is not a good thing because this may point to potential problems like hip impingement, pigeon-toed walking, patellofemoral pain syndrome, and femoral torsion syndrome
  • Retroversion - this is the result if the angle of rotation is below 8 degrees. This is also not a good thing because it may also point to potential problems, like the degeneration of the hip, hip arthritis, loss of balance, and more

To confirm your findings based on this test, it’s recommended that you endorse them for other tests, like X-ray and MRI.

Craig’s Test Example

The Craig’s Test normally doesn’t have any templated documents, so we took the liberty to create one that you can download for your work! It includes the instructions in this guide as well as editable fields for clerical information like your patient’s name and your name, the measurements for both femurs, and an additional comments box where you can talk about your findings and decisions related to the results.

Download this Craig’s Test Example (Sample) here:

Craig’s Test Example

If you like what you see and think this template will help streamline your work, feel free to download it for free! You can print it and fill it out using a pen, or if you’d rather go paperless, you can just fill out the PDF online.

When is the best time to administer the Craig’s Test?

The Craig’s Test is often included as one of the tests conducted during comprehensive musculoskeletal examinations. The reason for this is that sometimes the results you get do not necessarily give the full picture of the patient.

The results may point to certain complications, and those complications might require other tests in order to be properly assessed. If you are part of a team that conducts comprehensive musculoskeletal examinations, this is definitely one of the tests you should include when checking on a patient’s lower extremities.

While comprehensive musculoskeletal examinations normally include Craig’s Test, that doesn’t mean it can’t be used outside of such examinations. You can certainly use this before operating on patients to see if the femurs need to be operated on. If you are a sports therapist or physician, this can be used to assess any players for possible injuries sustained during a training session or an actual competitive sporting event.

You may also administer this test as part of a routine checkup in order to see if a patient is improving in terms of their femoral anteversion or retroversion, all the more after a surgery (wait for them to heal up, of course) or after a rehabilitation/treatment plan was created and implemented.

What are the benefits of the Craig’s Test?

It can provide valuable results that can be used for a wider examination.

To reiterate, the Craig’s Test is not a diagnostic test, but any results you get from this test will serve as valuable information when passed on to other members of a wider team conducting a comprehensive musculoskeletal examination of a patient. The results should point to possible issues in the femur and/or hip. These results will determine what other tests should be conducted and actual diagnostic tests to confirm suspicions.

The results can guide professionals when it comes to determining what to do for the patient.

Just like how the results of this test can determine what other tests should be included in a comprehensive examination, it can also guide healthcare professionals in making decisions regarding a patient’s treatment.

Let’s say that based on the results of this test, a patient is suspected of having a problem with their hip because of heightened femoral anteversion, and the hip is confirmed not to be aligned by an imaging test, then surgery will likely be a requirement in order to align the hip again.

It can be used as a monitoring test during routine checkups.

Earlier, we mentioned that this could be used as a monitoring test, Let’s stipulate that you have a patient who is undergoing a rehabilitation program for their hip. Based on findings, they do have issues with their hip, but they don’t require surgery.

You can administer this test every now and then to check if they are improving or not. If they are improving, then great! If not, then you might want to tweak the rehabilitation plan, or maybe they are worse and have developed an actual problem in their hip, which means that a comprehensive examination must be conducted again in order to see if they require surgery this time.

Why use Carepatron for physical therapy-related work?

One of the points that we reiterated throughout this article is that Craig’s Test is, more often than not, included in comprehensive musculoskeletal examinations. Based on that, you know that other tests make up that comprehensive examination. If you are a physical therapist or an orthopedist, and you are looking for possible assessments and techniques to include in your comprehensive examination, then check out Carepatron!

Carepatron houses a repository of resources that cover a wide range of healthcare fields, especially physical therapy. If you take your time and browse our roster of resources, you will find a wide variety of tests that you can conduct as part of your comprehensive examination of a patient! We’re sure you’ll find one, two, or more that might benefit your work. You can even download as many assessments as you want for free!

Apart from resources, Carepatron will also grant you access to a highly secure storage system where you can store your clinical files in a HIPAA-compliant manner. Let’s say you downloaded our template for the Craig’s Test, and you filled up a bunch of copies. You can store them with us and essentially make digital backups. You can even set up who can access them, so if you are part of a wider team, grant them access. This is so they can simply check your files in the storage and get what they need immediately without having to find you in the clinic or hospital.

We’re all about helping healthcare professionals with their work, so take advantage of our platform so we can help streamline your workflows and help you preserve your work!

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Is the Craig’s Test painful for patients?
Is the Craig’s Test painful for patients?

Commonly asked questions

Is the Craig’s Test painful for patients?

Normally, no, because the healthcare professional administering it (supposedly) knows what they are doing. However, patients should not be surprised if they feel discomfort or pressure on their hips/knees, especially if they are already painful in the first place.

How long does it take to accomplish this test?

Since the test only requires a flat surface and a goniometer, it shouldn’t take long to accomplish the whole test, including the measurement part. It should only take anywhere between 5 to 10 minutes.

What kinds of issues can the Craig’s Test identify?

That depends on the result of the test. If the results show heightened anteversion, some of the possible issues that can be identified are hip impingement, pigeon-toed walking, patellofemoral pain syndrome, and femoral torsion syndrome. If the results point to retroversion, degeneration of the hip or hip arthritis are among the issues that can be possibly identified.

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