The Craig Test, also called the Ryder Test or Trochanteric Prominence Angle Test, is a clinical method used to estimate femoral anteversion by palpating the greater trochanter during prone hip rotation. It can provide useful context for hip rotation, gait, squat mechanics, in-toeing, out-toeing and lower-limb alignment, but it does not replace CT or MRI-based femoral version measurement. Results should be interpreted alongside hip rotation range of motion, movement assessment, symptoms, sport demands and, where needed, imaging.

Introduction

Femoral version can influence hip rotation range, walking mechanics, squat position, running movement, knee alignment and sport-specific loading. Some clients naturally have more femoral anteversion, while others may have lower anteversion or relative retroversion.

The Craig Test is a practical clinical assessment used to estimate femoral anteversion. It is performed in prone with the knee flexed to 90 degrees while the examiner palpates the greater trochanter and rotates the hip until the greater trochanter is most prominent laterally.

The test can add useful context to hip and lower-limb assessment, but it should be interpreted cautiously. Femoral version is a structural measurement, and imaging-based methods such as CT or MRI are more precise when exact femoral version measurement is required. Research in people with chronic hip joint pain and asymptomatic controls found that Craig’s Test correlated with MRI-measured femoral version, but hip rotation range-of-motion variables also provided useful screening information.  

Quick Summary

• Test name: Craig Test
• Also known as: Craig’s Test, Ryder Test, Trochanteric Prominence Angle Test, TPAT
• Region: Hip and femur
• Test type: Clinical estimate of femoral anteversion / femoral version
• Client position: Prone
• Knee position: Flexed to approximately 90 degrees
• Key action: Palpate the greater trochanter while rotating the hip
• Measurement: Angle of the tibia/lower leg from vertical when the greater trochanter is most prominent laterally
• Positive or notable finding: Higher or lower measured version compared with expected range, side-to-side difference or movement presentation
• Best used with: Hip internal/external rotation ROM, gait, squat, running assessment and imaging when exact measurement is required
• Key limitation: Clinical palpation does not replace CT or MRI-based femoral version assessment

What Is the Craig Test?

The Craig Test is a clinical test used to estimate femoral anteversion.

Femoral anteversion describes the forward orientation of the femoral neck relative to the femoral condyles. Higher anteversion is often associated with greater available hip internal rotation and less external rotation. Lower anteversion or relative retroversion may be associated with less internal rotation and greater external rotation, although individual movement patterns vary.

The test is performed by:

• placing the client in prone
• flexing the knee to 90 degrees
• palpating the greater trochanter
• rotating the hip internally and externally
• identifying the hip rotation position where the greater trochanter is most prominent laterally
• measuring the angle of the tibia/lower leg from vertical

The test is commonly described as the Trochanteric Prominence Angle Test because the examiner uses the position of the greater trochanter to estimate when the femoral neck is parallel to the table.  

Why It Is Used

The Craig Test is used to add structural and movement context.

It may help professionals understand why a client presents with:

• increased hip internal rotation
• limited hip external rotation
• in-toeing gait
• out-toeing gait
• altered squat mechanics
• dynamic knee valgus tendencies
• patellofemoral loading concerns
• hip impingement-like movement limitations
• asymmetrical hip rotation
• sport-specific movement differences

The test can help answer questions such as:

• Does the client’s hip rotation pattern appear consistent with increased femoral anteversion?
• Is one side meaningfully different from the other?
• Are movement findings likely influenced by structural hip version?
• Should training cues be adapted to the client’s available hip rotation?
• Is imaging or medical review needed for exact structural measurement?

It should support assessment reasoning, not replace broader assessment.

What It Assesses

The Craig Test estimates:

• femoral anteversion
• femoral version category
• side-to-side femoral version difference
• relationship between hip structure and hip rotation ROM
• possible structural influence on lower-limb mechanics

It may provide context for:

• hip internal rotation dominance
• hip external rotation limitation
• in-toeing
• out-toeing
• squatting mechanics
• running mechanics
• knee alignment
• hip joint loading
• patellofemoral loading

It does not directly assess or confirm:

• hip pathology
• femoroacetabular impingement
• labral tear
• hip dysplasia
• patellofemoral pain cause
• exact femoral torsion
• need for imaging
• readiness to return to sport

Who It Is Useful For

The Craig Test may be useful for:

• exercise professionals
• strength and conditioning coaches
• allied health support teams
• sport and performance staff
• movement assessment professionals
• students learning hip assessment
• professionals using Measurz or MAT for structured assessment recording

It may be relevant for clients with:

• hip rotation asymmetry
• in-toeing or out-toeing gait
• altered squat mechanics
• knee valgus movement patterns
• hip pain with rotation-based tasks
• patellofemoral pain presentations
• sport-specific cutting, landing or pivoting issues
• suspected structural influence on movement
• unexplained differences between left and right hip rotation

It may be less useful if the assessment question is primarily pain provocation, acute injury diagnosis or return-to-sport clearance.

When to Use This Test

Use the Craig Test when you want to estimate whether femoral version may be influencing hip rotation or lower-limb movement.

It may be used during:

• hip assessment
• lower-limb movement screening
• gait assessment
• running assessment
• squat or lunge assessment
• in-toeing or out-toeing review
• patellofemoral pain assessment
• hip rotation asymmetry assessment
• sport movement review
• reassessment after technique changes

The test may be especially useful when hip ROM findings show:

• much more internal rotation than external rotation
• much more external rotation than internal rotation
• large side-to-side asymmetry
• hip rotation findings that affect exercise setup or sport technique

When Not to Use or When to Be Cautious

Use caution when the client has:

• acute hip trauma
• suspected fracture
• severe hip pain
• recent surgery without appropriate clearance
• inability to lie prone
• severe knee pain limiting knee flexion
• high irritability with passive hip rotation
• symptoms that worsen sharply during testing
• neurological or systemic symptoms requiring further assessment

Avoid over-interpreting the test when:

• palpation is difficult
• body composition limits landmark confidence
• hip rotation is painful or guarded
• the client cannot relax
• the examiner cannot reliably identify the greater trochanter
• exact femoral version is required

When exact structural measurement matters, imaging-based assessment is more appropriate.

Equipment Required

Required:

• firm plinth or mat
• goniometer or inclinometer
• Measurz recording workflow

Optional:

• digital inclinometer
• smartphone inclinometer app
• skin marker for landmarks
• towel support for comfort
• hip ROM record
• gait or movement video notes

A study comparing goniometer and inclinometer methods noted that locating and maintaining the greater trochanter position can be difficult, especially while also controlling hip rotation and measuring the tibial angle.  

Step-by-Step Protocol / Practice

Setup

Explain the purpose of the test.

Example wording:

“We are going to estimate the rotational position of your femur by feeling where the greater trochanter becomes most prominent during hip rotation. This does not diagnose a condition or replace imaging, but it can help us understand your hip rotation and movement pattern.”

Client Position

Position the client:

• prone
• hips neutral
• pelvis level
• tested knee flexed to 90 degrees
• opposite leg relaxed
• trunk relaxed
• head and arms comfortable

Check that:

• the pelvis is not rotating
• the hip is not abducted or adducted excessively
• the client can relax the tested leg
• knee flexion does not cause pain

Examiner / Professional Position

Stand beside the tested hip.

You need to be able to:

• palpate the greater trochanter
• rotate the hip by moving the lower leg
• maintain knee flexion
• observe or measure tibial angle
• avoid forcing the hip into painful rotation

Hand Placement

Common hand placement:

• one hand palpates the greater trochanter
• the other hand controls the distal tibia or ankle
• the hip is rotated internally and externally until the greater trochanter is most prominent laterally

The palpating hand should stay on the greater trochanter throughout the movement.

Movement Direction

Move the lower leg to rotate the hip:

• moving the foot outward generally creates hip internal rotation
• moving the foot inward generally creates hip external rotation

Continue rotating until the greater trochanter feels most prominent laterally. This is interpreted as the point where the femoral neck is positioned most horizontally.

Measurement

At the point where the greater trochanter is most prominent:

• stop the movement
• hold the limb still
• measure the angle of the tibia/lower leg from vertical
• record the angle in degrees
• record whether the angle is toward internal or external rotation
• repeat for reliability if appropriate

Use the same measurement tool and method at retest.

Suggested Trial Method

For repeatability:

• perform one gentle familiarisation trial
• perform two or three measured trials
• record each trial
• use the average or most consistent value
• repeat on the other side
• record side-to-side difference

Positive or Notable Finding

The Craig Test is not usually interpreted as a simple positive or negative pain test.

A notable finding may be:

• increased estimated femoral anteversion
• decreased estimated femoral anteversion
• relative femoral retroversion
• meaningful side-to-side difference
• finding that matches hip rotation ROM pattern
• finding that explains movement strategy or alignment

Negative or Unremarkable Finding

An unremarkable finding may be:

• estimated version within expected adult range
• no meaningful side-to-side difference
• measurement does not appear to explain the movement finding
• result is unclear due to palpation or guarding limitations

Stopping Criteria

Stop the test if:

• hip pain increases sharply
• the client cannot tolerate prone position
• knee pain limits the setup
• the client guards strongly
• the greater trochanter cannot be palpated confidently
• the result will not be reliable
• further assessment is more appropriate

Positive and Negative Test Interpretation

Notable Test Result

A notable Craig Test result may suggest that femoral version could be influencing movement or hip rotation.

A higher estimated anteversion may be associated with:

• greater hip internal rotation
• reduced hip external rotation
• in-toeing tendency
• squatting or landing with more internally rotated femur
• altered patellofemoral loading context

A lower estimated anteversion or relative retroversion may be associated with:

• reduced hip internal rotation
• greater hip external rotation
• out-toeing tendency
• earlier bony or movement limitation in deep flexion or rotation tasks
• altered hip loading context

These are associations, not diagnoses.

Unremarkable Test Result

An unremarkable Craig Test result may suggest that femoral version is less likely to be a major contributor to the movement or ROM finding.

However, this does not rule out:

• hip joint pathology
• soft tissue restriction
• motor control strategy
• pain-related guarding
• sport-specific movement adaptation
• other structural contributors

What the Test Does Not Prove

The Craig Test does not prove:

• hip diagnosis
• labral pathology
• femoroacetabular impingement
• hip dysplasia
• patellofemoral pain source
• structural abnormality requiring intervention
• exact femoral version
• return-to-sport readiness

How to Explain the Result Safely

Example wording:

“Your Craig Test suggests your hip structure may allow more internal rotation on this side. That does not diagnose a problem, but it may help explain why some positions feel more natural than others and why we may adjust exercise setup or technique.”

Sensitivity, Specificity and Diagnostic Accuracy

Sensitivity and specificity are not usually the best way to describe the Craig Test because it is not a diagnostic provocation test for a disease. It is a clinical estimate of femoral version.

Diagnostic Accuracy for Femoral Version Category

Research comparing Craig’s Test with MRI-measured femoral version found a moderate relationship. In people with chronic hip joint pain and matched controls, Craig’s Test correlated with MRI femoral version at r = 0.61, while hip internal rotation at 90 degrees and the difference between internal and external rotation also correlated with MRI version. The authors concluded that hip rotation ROM and Craig’s Test may be used for screening when imaging is not indicated.  

This means Craig’s Test may help screen or estimate femoral version context, but it should not be treated as a precise replacement for imaging.

Imaging Comparison

CT and MRI are commonly used to quantify femoral version when exact measurement is required. A 2020 comparison study stated that CT and MRI can be useful for accurate quantitative analysis, while Craig’s Test remains a commonly used physical examination method in clinical practice.  

Sensitivity and Specificity Values

High-quality sensitivity, specificity and likelihood ratio values for Craig’s Test as a stand-alone classifier of excessive anteversion or retroversion are not consistently established for routine clinical use.

For Measurz interpretation:

• Do not claim the test diagnoses femoral anteversion abnormality.
• Do not use it as a pass/fail test.
• Use it as a clinical estimate.
• Compare with hip rotation ROM and movement findings.
• Consider imaging when exact femoral version matters.

Reliability and Validity

Craig Test reliability and validity depend heavily on examiner skill, landmark palpation and measurement method.

A reliability study noted that Craig’s Test is widely used but can be difficult because the examiner must palpate the greater trochanter, maintain hip rotation and measure the tibial angle at the same time. This can affect consistency between examiners.  

A 2013 study reported that a wide range of intra-rater and inter-rater reliability values had been reported for the Trochanteric Prominence Angle Test and compared it with an alternative transcondylar angle method using a smartphone as a measurement tool.  

A 2018 controlled laboratory study found that Craig’s Test had a moderate correlation with MRI-measured femoral version and that hip rotation ROM variables also related to femoral version categories.  

Reliability is stronger when you standardise:

• client prone position
• knee flexion angle
• hip neutral starting position
• pelvis control
• palpation landmark
• measurement tool
• tibial reference line
• number of trials
• examiner training
• side order
• recording method

Validity is stronger when Craig Test findings match:

• hip internal/external rotation pattern
• gait or foot progression angle
• squat or lunge mechanics
• running mechanics
• symptoms and function
• imaging findings where available

Normative Data, Benchmarks or Reference Values

Evidence level: Level 2 — practical benchmark guidance is available, but values should be used as context rather than strict pass/fail thresholds.

Adult femoral anteversion is often described as commonly sitting around 8–15 degrees, but published values vary depending on age, method, imaging technique and reference standard. Educational summaries note that femoral anteversion decreases with growth and that adult averages are commonly lower than childhood values.  

Use reference values cautiously because femoral version differs by:

• age
• sex
• measurement method
• imaging protocol
• sport
• activity history
• ethnicity
• hip symptoms
• developmental history
• side-to-side variation

Practical interpretation guidance:

• Compare left and right sides.
• Compare Craig Test with hip IR and ER ROM.
• Compare with gait, squat and sport movement.
• Record whether the result explains the movement pattern.
• Use imaging when exact measurement matters.
• Do not label a result abnormal based on one clinical estimate alone.

Common Errors and Limitations

Common errors include:

• treating the test as diagnostic
• calling femoral anteversion “pathology”
• not recording the measured angle
• not recording side tested
• not controlling pelvic rotation
• failing to keep the knee at 90 degrees
• palpating the wrong landmark
• forcing the hip into painful rotation
• measuring from an inconsistent vertical reference
• using different tools across sessions
• comparing results without noting examiner or method
• ignoring hip ROM and movement findings

Limitations include:

• palpation can be difficult
• inter-rater reliability may vary
• hip pain or guarding can affect results
• body composition can make landmarks harder to identify
• the test estimates rather than directly measures femoral version
• CT or MRI is more precise for structural measurement
• sensitivity and specificity are not well established for routine classification
• movement is influenced by more than femoral version alone

Practical Applications

The Craig Test may help with:

• hip rotation interpretation
• exercise setup decisions
• squat stance education
• running and gait analysis context
• lower-limb alignment assessment
• in-toeing or out-toeing interpretation
• side-to-side comparison
• sport movement discussion
• referral reasoning when structural measurement is important

Examples:

• A client with high internal rotation, limited external rotation and a higher Craig Test angle may naturally prefer narrower or internally rotated positions.
• A client with lower internal rotation, more external rotation and a lower Craig Test angle may need different squat, lunge or cutting setup options.
• An athlete with asymmetrical Craig Test findings may need side-specific interpretation rather than being forced into identical movement cues.

The Craig Test is most useful when it helps explain movement options and guides individualised setup, not when used to label the client as abnormal.

How to Record This in Measurz

Record:

• test name: Craig Test / Ryder Test / Trochanteric Prominence Angle Test
• side tested: left or right
• client position: prone
• knee angle: approximately 90 degrees
• hip starting position
• measurement tool: goniometer, inclinometer or smartphone inclinometer
• measured angle in degrees
• direction: anteversion estimate, neutral or retroversion estimate
• trial values
• selected value: best, average or most consistent
• side-to-side difference
• pain during test: yes/no
• pain score if relevant
• palpation confidence
• guarding or compensation
• pelvic movement
• examiner notes
• related hip ROM:
  • hip internal rotation at 90 degrees
  • hip external rotation at 90 degrees
  • hip IR/ER difference
  • hip rotation in neutral if assessed
• related movement findings:
  • gait
  • squat
  • lunge
  • running
  • landing
• symptoms and body region
• dominance if relevant
• imaging findings if available
• interpretation notes
• retest date if monitoring
• referral or further assessment notes if appropriate

Recording these details improves:

• repeatability
• communication
• client education
• assessment reasoning
• movement interpretation
• team consistency
• reporting quality

Related Tests / Internal Links

• FADIR Test
• FAIR Test
• Hip Quadrant Test
• McCarthy Test
• Adductor Squeeze Test
• Femoral Nerve Tension Test
• Piriformis Test
• Lower Extremity Functional Scale
• Hip Disability and Osteoarthritis Outcome Score

FAQs

What does the Craig Test measure?

The Craig Test estimates femoral anteversion by palpating the greater trochanter during prone hip rotation and measuring the lower-leg angle when the trochanter is most prominent laterally.

Is the Craig Test the same as the Ryder Test?

Yes. Craig Test and Ryder Test are commonly used names for the same femoral anteversion assessment. It is also called the Trochanteric Prominence Angle Test.

Can the Craig Test diagnose femoral anteversion?

No. It can estimate femoral version clinically, but it does not replace CT or MRI when exact structural measurement is required.

What is a normal Craig Test angle?

Adult femoral anteversion is often described around 8–15 degrees, but normal values vary by age, sex, method and population. Use values as context rather than strict pass/fail cut-offs.  

Is the Craig Test reliable?

Reliability can vary. It improves when the examiner standardises prone position, knee angle, greater trochanter palpation, measurement tool and trial method. Inter-examiner reliability may be affected by landmark palpation difficulty.  

How does the Craig Test compare with MRI?

A study found Craig’s Test had a moderate correlation with MRI-measured femoral version. It may be useful for screening when imaging is not indicated, but it is not a direct substitute for MRI.  

Should Craig Test results change exercise technique?

They may guide individualised setup. For example, hip version may help explain why some squat, lunge or running positions feel more natural. Results should be combined with symptoms, strength, ROM and movement quality.

Key Takeaways

• The Craig Test estimates femoral anteversion clinically.
• It is performed prone with the knee flexed to approximately 90 degrees.
• The examiner palpates the greater trochanter and measures the lower-leg angle when the trochanter is most prominent laterally.
• It can support interpretation of hip rotation, gait, squat and lower-limb alignment.
• It does not diagnose hip pathology or replace CT/MRI-based femoral version measurement.
• Reliability depends on palpation skill, positioning, measurement tool and repeatability.
• Measurz should record side, angle, tool, trials, palpation confidence, hip ROM, movement findings and interpretation notes.

References

Choi, B.-R., Kang, S.-Y., & Hwang, Y.-I. (2015). Intra- and inter-examiner reliability of goniometer and inclinometer use in Craig’s test. Journal of Physical Therapy Science, 27(4), 1141–1144. https://doi.org/10.1589/jpts.27.1141

Kim, H.-Y., Lee, S.-K., Lee, N.-K., Choy, W.-S., & Lee, D.-H. (2020). Differences between Craig’s test and computed tomography in measuring femoral anteversion. Journal of Physical Therapy Science / related open-access clinical measurement literature. https://pmc.ncbi.nlm.nih.gov/articles/PMC7276780/

Lewis, C. L., & Sahrmann, S. A. (2015). Acetabular labral tears. Physical Therapy, 86(1), 110–121. https://doi.org/10.1093/ptj/86.1.110

Souza, R. B., & Powers, C. M. (2009). Concurrent criterion-related validity and reliability of a clinical test to measure femoral anteversion. Journal of Orthopaedic & Sports Physical Therapy, 39(8), 586–592. https://doi.org/10.2519/jospt.2009.2996

Uding, A., Bloom, N. J., Commean, P. K., Hillen, T. J., Patterson, J. D., Clohisy, J. C., & Harris-Hayes, M. (2019). Clinical tests to determine femoral version category in people with chronic hip joint pain and asymptomatic controls. Musculoskeletal Science and Practice, 39, 115–122. https://doi.org/10.1016/j.msksp.2018.12.003

Yoo, J.-H., et al. (2013). A comparison of the reliability of the trochanteric prominence angle test and the transcondylar angle test for femoral neck anteversion. Manual Therapy, 18(6), 484–488. https://doi.org/10.1016/j.math.2013.05.005