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Forceful upwards thrust to the heel


This provocation test may be used to provoke groin pain when an incipient aseptic necrosis of the hip is feared.

Positioning. .

The subject lies supine with the hip slightly abducted and externally rotated, and the knee extended. The examiner stands at the footend of the couch. One hand carries the heel and lifts the extended leg to 45°.


A forceful upwards blow on the heel, aXially in the direction of the hip, that provokes groin pain is suggestive of an incipient aseptic necrosis, even in the absence of radiographic signs. Further investigation is mandatory.

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