Are you a ballet dancer, weightlifter, soccer player, or runner? Does your hip make a clicking sound while you walk? Do you have occasional stiffness in the front, side, or back of your hip? Do you have weakness in your legs? If you answered yes to any of these questions, then you may have snapping hip syndrome. Read the details below for more information.

What is Snapping Hip Syndrome (Coxa Saltans)?

Snapping hip syndrome is a condition in which an audible snapping sound is heard or a palpable snapping sensation is felt during movement of the hip joint.
● Only 5% to 10% of the population is affected.
● This condition occurs more in women than men.
● The groups affected are:
o Ballet dancers
o Weightlifters
o Soccer players
o Runners
Snapping hip syndrome is classified into three main categories based on the anatomical structure that causes the source of the snapping sensation:

o 1) Internal
o 2) External
o 3) Intra-articular (labral tears of the hip)

Symptoms

● Snapping in the front, back, or side of the leg when moving the hip
● Tightness in the hip, usually the front or the back
● Swelling in the hip
● Weakness in the leg
● Difficulty moving the hip

Causes

● External snapping hip is caused by the iliotibial band (IT band) moving over the greater trochanter of the femoral head during hip movement in flexion, extension, and external or internal rotation of the hip.
● Internal snapping hip is caused by the proximal hamstring tendon rolling over the ischial tuberosity, the fascia lata, or the anterior gluteus maximus muscle rolling over the greater trochanter; and the psoas tendon rolling over the fibers of the iliacus muscle.
● The intra-articular snapping hip is caused by a labral tear in the cartilage of the acetabulum.

Diagnosis

● This condition is confirmed using iliopsoas bursography combined with fluoroscopy, ultrasound, magnetic resonance imagery (MRI) or magnetic resonance angiography (MRA).
o An external snapping hip can be clinically diagnosed on MRI as a thickened IT band or thickened anterior edge of the gluteus maximus.
o If not visible, an ultrasound can be used to demonstrate the snapping on the iliotibial band over the greater trochanter.
o An ultrasound will be able to reveal tendonitis, iliopsoas bursitis, or muscle tears.

Treatment

● Treatment depends on the severity.
● When painless, treatment is not necessary.
● When pain is present, the treatment plan includes:
o Rest
o Stretching
o Steroid injections
o Oral NSAIDs
o Physical therapy
o Modified physical activity
● If pain continues, arthroscopic surgery may be necessary.

Snappy Hip Syndrome
Figure 1: Painful hip skeleton Xray.

References

MDGRPHCS. (2020). [Illustration]. 3D illustration, hip painful skeleton x-ray, medical concept. https://www.shutterstock.com/image-illustration/3d-illustration-hip-painful-skeleton-xray-1074188606

Musick SR & Varacallo M. (2020). Snapping Hip Syndrome. https://www.ncbi.nlm.nih.gov/books/NBK448200/

Stanford Health Care. (2020). Snapping Hip Syndrome. https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/snapping-hip-syndrome.html

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