Hip Orthopaedic Test: McCarthy Test

The McCarthy Test is a hip special test used to assess whether controlled hip movement reproduces symptoms commonly associated with intra-articular hip irritation. A positive test may include familiar hip or groin pain, clicking, catching or painful mechanical symptoms. Current evidence for the exact McCarthy Test appears limited, so it should be interpreted as one part of a broader hip assessment rather than as a stand-alone diagnostic test.

Introduction

A client reports deep groin pain and intermittent catching during pivoting and deep hip flexion. Hip ROM is uncomfortable near flexion and rotation. The McCarthy Test may help reproduce familiar symptoms during a controlled hip movement sequence.

The test is often discussed in relation to acetabular labral pathology, but labral tears can be present in asymptomatic people and clinical tests alone are not enough to confirm the source of pain. A 2020 evidence update on acetabular labral tears notes that imaging and intra-articular injections may be needed alongside history and physical examination in some cases.  

Quick Summary

Test name: McCarthy Test
Body region: Hip
Purpose: Assess hip symptom response during movement from flexion into extension with rotation
Commonly associated with: Labral or intra-articular hip symptom provocation
Positive finding: Familiar hip/groin pain, clicking, catching or painful mechanical symptoms
Negative finding: No familiar symptoms during the movement sequence
Best used with: Hip ROM, FADIR, FABER, Hip Quadrant Test, gait, squat and symptom history
Key limitation: High-quality diagnostic accuracy evidence for the exact McCarthy Test appears limited

What Is the McCarthy Test?

The McCarthy Test is a passive hip movement test. The client lies supine while both hips are flexed. The non-tested hip remains flexed while the tested hip is moved from flexion toward extension, often with rotation added depending on the protocol.

The test attempts to reproduce symptoms that may be associated with intra-articular hip irritation.

Why It Is Used

It is used to explore whether hip movement reproduces the client’s familiar symptoms, especially deep groin pain, clicking, catching or painful mechanical symptoms.

What It Assesses

The test assesses symptom response during hip movement. It does not isolate the labrum or confirm a labral tear.

Who It Is Useful For

This test may be useful for clients with deep anterior hip or groin symptoms, painful catching, pivoting-related symptoms, squat-related hip pain or suspected intra-articular hip involvement.

When to Use This Test

Use when hip joint involvement is part of the clinical reasoning and passive movement can be performed safely.

When Not to Use or When to Be Cautious

Use caution with acute injury, high irritability, suspected fracture, severe guarding, recent surgery or symptoms that worsen quickly with passive hip movement.

Equipment Required

Treatment table
Pain scale
Measurz recording workflow
Optional comparison side notes

Step-by-Step Protocol / Practice

Setup

Position the client supine.

Client position

Flex both hips fully or to the available comfortable range.

Examiner position

Stand at the foot or side of the table.

Hand placement

Support the tested leg around the knee and lower leg.

Stabilisation

The client or examiner maintains the opposite hip in flexion while the tested hip is moved.

Movement or force direction

Move the tested hip from flexion toward extension. Depending on the protocol, add internal and external rotation during the movement.

Instructions

Ask the client to report pain, clicking, catching, pinching and whether the symptoms are familiar.

Positive finding

Reproduction of familiar hip/groin pain, painful clicking, catching or mechanical symptoms.

Negative finding

No reproduction of familiar symptoms.

Stopping criteria

Stop if pain increases sharply, guarding occurs or movement is not tolerated.

Safety notes

Avoid forcing hip extension or rotation. Keep the movement controlled.

Positive and Negative Test Interpretation

A positive McCarthy Test may increase suspicion of intra-articular hip symptom involvement when it reproduces familiar deep hip or groin pain, clicking or catching. It does not confirm labral pathology.

A negative test may reduce suspicion when history and other hip tests are also not suggestive, but it does not exclude labral or intra-articular pathology.

Interpretation is stronger when combined with hip ROM, symptom behaviour, FADIR, FABER, Hip Quadrant Test, functional movements and imaging where appropriate.

Sensitivity, Specificity and Diagnostic Accuracy

High-quality 2020+ diagnostic accuracy evidence for the exact McCarthy Test appears limited.

A recent systematic review of physical examination tests for prearthritic intra-articular hip pathology reported ongoing uncertainty and variation in diagnostic accuracy across hip tests, populations and reference standards.  

No 2020+ sensitivity, specificity or likelihood ratio values for the exact McCarthy Test were identified from the available evidence, so no values are listed.

Reliability and Validity

Current reliability evidence for the exact McCarthy Test appears limited. Reliability depends on consistent hip flexion range, movement speed, rotation direction, symptom criteria and examiner control.

Common Errors and Limitations

Common errors include forcing end range, interpreting clicking without pain as positive, failing to ask whether symptoms are familiar, using inconsistent rotation direction and treating the test as diagnostic.

Limitations include poor structural specificity, variable protocol descriptions and overlap with other hip, lumbar and pelvic presentations.

Practical Applications

Use the McCarthy Test to record symptom behaviour during hip movement. It may help guide whether further hip ROM, strength, functional or imaging-related assessment is appropriate.

How to Record This in Measurz

Record test name, side tested, result, pain score, symptom location, symptom quality, movement direction, hip position, whether clicking or catching occurred, whether symptoms were familiar, comparison side, irritability, confidence in result and reason for stopping.

Add related findings such as FADIR, FABER, Hip Quadrant Test, hip internal rotation, squat response and gait findings.

Related Tests / Internal Links

Hip Quadrant Test
FADIR Test
FABER Test
Hip Internal Rotation Test
Hip External Rotation Test
Straight Leg Raise Test
Squat Assessment

FAQs

What does the McCarthy Test assess?

It assesses whether controlled hip movement reproduces familiar hip or groin symptoms.

Does a positive McCarthy Test confirm a labral tear?

No. It may increase suspicion but does not confirm a labral tear.

What is a positive finding?

Familiar hip/groin pain, painful clicking, catching or mechanical symptoms during the movement.

Why is symptom familiarity important?

A test is more meaningful when it reproduces the client’s usual symptoms rather than unrelated discomfort.

Key Takeaways

The McCarthy Test is a hip symptom provocation test.
A positive finding may suggest intra-articular involvement but is not diagnostic.
Current diagnostic accuracy evidence for the exact test is limited.
Record movement direction, symptoms and comparison side carefully.

References

Packer, J. D., et al. (2025). Sensitivity and specificity for physical examination tests in diagnosing prearthritic intra-articular hip pathology: A systematic review. Journal of Hip Preservation Surgery. Needs verification.

Sogbein, O. A., Shah, A., Kay, J., et al. (2020). Update on evidence-based diagnosis and treatment of acetabular labral tears. Current Reviews in Musculoskeletal Medicine, 13, 763–772. Needs verification.