Understanding and Treating the Snapping Hip

Abstract

Snapping hip, or coxa saltans is a palpable or auditory snapping with movement of the hip joint. Extra-articular snapping is divided into external and internal types, and is caused laterally by the iliotibial band and anteriorly by the iliopsoas tendon. Snapping of the iliopsoas usually requires contraction of the hip flexors and may be difficult to distinguish from intra-articualar coxa saltans. Ultrasound can be a useful modality to dynamically detect tendon translation during hip movement to support the diagnosis of extra-articular snapping. Coxa saltans is typically treated with conservative measures including anti-inflammatories, stretching and avoidance of inciting activities. Recalcitrant cases are treated with surgery to lengthen the iliopsoas or iliotibial band.

Peritrochanteric Endoscopy

“…The presence of visual or auditory snapping can assist in making this distinction. 15,16 Symptomatic extra-articular coxa saltans is thought to more commonly occur in athletes, particular those participating in activities where the extremes of motion are frequently tested. 4,16 Though often benign, symptoms can be concerning to patients.…”

“…It is important to note that intra-and extra-articular coxa saltans can occur simultaneously so thorough evaluation is crucial. [15][16][17] Extra-articular coxa saltans is comprised of two distinct entities: coxa saltans interna and coxa saltans externa. Coxa saltans interna is attributed to snapping of the iliopsoas tendon, while coxa saltans externa is due to snapping of the posterior iliotibial band or anterior gluteus medius.…”

Diagnosis and Management of Snapping Hip Syndrome: A Comprehensive Review of Literature

“…With the patient is standing position, the hula-hoop test consists in adduction with circumduction of the affected hip. If the circumduction results in a snap over the greater trochanter, the test is positive for ESHS [14]. The modified FABER test usually cause discomfort to the patient (Figure 2).…”

The Hip Restoration Algorithm

“…28 . Expectation: Revealing of symptoms by treatment: Conservative with anti-inflammatory drugs, physical therapy, home exercises, and steroid injections.…”