Anvil Test

Indications

Anvil test, sometimes also referred to as Supported Adam’s test is a provocative orthopaedic hip examination often used to determine if there is hip joint pathology, for example, hip arthritis, femoral neck/head fracture and infection.

Procedure

  1. Patient supine, examiner flexes patient’s leg straight to 30°.
  2. Examiner then applies gentle axis compression to the leg (compressing hip joint)
  3. Examiner finally strikes the patient’s heel.
Anvil test for hip pathology

Examiner applies gentle axis compression to the leg after rising it to 30°. Examiner finally strikes the patient’s heel.

Interpretation

Hip pain is a positive sign of this test, indicating possible hip pathology. If local femoral, tibial, fibular or calcaneal pain is elicited, consider a diagnosis of fracture, or strain/sprain in the region corresponding to the pain.

Positive Anvil Test

    Hip pain: Hip joint pathology, arthritis, femoral neck or head fracture, infection

Clinical Notes

Clinician’s option: examiner may choose to repeatedly strike the heel with increasing force each time for up to 3 percussions.