Execution
- 1Position the patient supine near the edge of the table.
- 2Flex the contralateral hip to control lumbar lordosis and pelvic position.
- 3Move the test hip into extension and external rotation without adding abduction.
- 4Apply gentle overpressure into the provocative position.
- 5Ask whether anterior hip pain, apprehension, or instability is reproduced.
Positive outcome
Reproduction of anterior hip pain or apprehension is positive. The response suggests anterior hip microinstability or anterior capsular / labral sensitivity. Relief with anterior hip relocation or reduced extension stress supports an instability interpretation.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Hoppe et al. (2017) | NA | 71.0 | 85.1 | 4.8 | 0.34 |
CommentHEER is less accurate than AB-HEER but still has moderate rule-in value in Hoppe’s cohort. It overlaps procedurally with anterior apprehension testing, so document the exact hip position. It should be used cautiously in irritable anterior hip pain or suspected instability after capsulotomy.
Moderate Clinical Value