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Snapping Hip

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Snapping Hip

WHAT IS IT?

In Latin this is known as “coxa saltans” (snapping hip syndrome).

Patients report or even hear a snap of their hip which comes from the side of the thigh or from the groin.

CAUSES

There are two types of snapping hip syndrome:

  • Intra-articular snapping hip syndrome: caused by the iliopsoas tendon grinding against the iliopectinal ridge of the pelvis
  • Extra-articular snapping hip syndrome: caused by the iliotibial band sliding back and forth against the greater trochanter

SYMPTOMS

Patients often report the sensation of the hip jumping (in some cases they say "my hip came out"). Frequently they are able to replicate this by making flexion-extension movements by rotating or adducting the hip.

Extra-articular snapping hip syndrome is far more common. In some cases, the patients replicate the jump and ask for advice regarding this but there is no pain. Clinical examination using the aforementioned action reveals the snapping hip.

When there is prolonged tension applied to the iliotibial band or the evolution period is long, walking, going up and down stairs, lying on the affected side or crossing one's legs may all be painful.

DIAGNOSIS

As with all pathologies of the musculoskeletal system, physical examination is extremely important and in this case it is even more important.

This can be combined with ultrasound or MRI which will inform us of the presence of swellings in the affected area (iliotibial band, bursa or greater trochanter in extra-articular snapping hip syndrome and the iliopsoas tendon in intra-articular snapping hip syndrome).

TREATMENT

If there is no pain, no treatment may be necessary. Most patients control the symptoms using a conservative approach.

Otherwise, as described for trochanteric bursitis, programmes to stretch the iliotibial band or the iliopsoas should be part of the first phase of treatment, in addition to non-steroidal anti-inflammatory medication.

In the event that there is no alleviation of the symptoms, cortico-steroid and local anaesthetic injections may be performed in the affected area or tendon.

As a last resort, and providing that after a prolonged period of non-surgical treatment it has been impossible to manage to control the symptoms, surgical treatment may be considered and this would involve some kind of technique to lengthen/relax either the iliotibial band or the ilioposoas tendon.


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