Test library › Hip, groin & thigh
Patellar-pubic percussion test
For: Occult hip fracture after trauma
A break at the top of the thigh bone (the hip) after a fall or injury that does not show on the first plain X-ray.
Treat with caution (see below)Its positive likelihood ratio reaches the usual rule-in threshold, but the book does not count it as a reliable rule-in test.
Its negative likelihood ratio reaches the usual rule-out threshold, but the book does not count it as a reliable rule-out test.
Caution: Later study, Smeets 2018: LR+ about 2.8, LR− about 0.21.
What the numbers mean
- Positive result: see the caution above before relying on this result.
- Negative result: see the caution above before relying on this result.
Source
Reiman MP, Goode AP, Hegedus EJ, Cook CE, Wright AA. Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis. Br J Sports Med. 2013;47(14):893–902. Journal article (DOI) · meta-analysis
Also cited: Smeets SJM, Vening W, Winkes MB, Kuijt GP, Slooter GD, van Eerten PV. The patellar pubic percussion test: a simple bedside tool for suspected occult hip fractures. Int Orthop. 2018;42(11):2521-2524. Journal article (DOI)
Figures as they will appear in Rule It In, Rule It Out (Trokos, forthcoming). If a newer or better study changes them, this page changes with the book. Figures last updated from the book on 2 October 2026.
Get the book for telling the hip joint from the lateral hip, and ruling out the runner's stress fracture first
This page gives the published figures. Rule It In, Rule It Out adds how to do this test, what counts as positive, how to read the result, and, where studied, whether combining it with other tests helps.
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Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.