Snapping Hip and Trochanteric Bursitis: Difference between revisions
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=== External Snapping Hip === | === External Snapping Hip === | ||
External (lateral) snapping hip is a painful condition also known as lateral coxa saltans. It occurs in about 10% of the general population | External (lateral) snapping hip is a painful condition also known as lateral coxa saltans. It occurs in about 10% of the general population.<ref>Randelli F, Mazzoleni MG, Fioruzzi A, Giai Via A, Calvisi V, Ayeni OR. [https://link.springer.com/article/10.1007/s00167-020-06305-w#citeas Surgical interventions for external snapping hip syndrome]. Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2386-2393. </ref> The ''external'' ''extra-articular'' factor involves the posterior iliotibial band snapping over the greater trochanter. <ref name=":0">Yen YM, Lewis CL, Kim YJ. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961351/pdf/nihms721941.pdf Understanding and Treating the Snapping Hip]. Sports Med Arthrosc Rev. 2015 Dec;23(4):194-9. </ref> Second ''external extra-articular'' mechanism leading to this condition involves the anterior aspect of the gluteus maximus traveling over the greater trochanter during hip flexion and extension or internal and external rotation of the hip and snapping over the greater trochanter. This may lead to the inflammation of the trochanteric bursa. <ref name=":0" />There are also ''external intra-articular'' factors which can lead to development of symptoms characterised this condition. They include labral tears, ligamentum teres tears, loose bodies such as osteochondral fragments, or an instability of the joint. | ||
=== Internal Snapping Hip === | === Internal Snapping Hip === | ||
Internal extra-articular snapping is caused by the iliopsoas tendon flipping over the iliopectinal eminence or the femoral head and often requires hip flexors contraction. Other proposed | ''Internal'' ''extra-articular'' snapping is caused by the iliopsoas tendon flipping over the iliopectinal eminence or the femoral head and often requires hip flexors contraction. Other proposed ''extra-articular'' mechanisms of this condition include: | ||
* accessory iliopsoas tendon slips | * accessory iliopsoas tendon slips | ||
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* subluxation of the long head of the biceps at the ischium | * subluxation of the long head of the biceps at the ischium | ||
* snapping at the anterior inferior iliac spine.<ref name=":0" /> | * snapping at the anterior inferior iliac spine.<ref name=":0" /> | ||
=== Intra-articular Snapping Hip === | |||
''The intra-articular'' factors can lead to development of snapping hip symptom. They include labral tears, ligamentum teres tears, loose bodies such as osteochondral fragments, or joint instability. | |||
==== Clinically Relevant Anatomy ==== | ==== Clinically Relevant Anatomy ==== | ||
Revision as of 19:09, 13 March 2022
Top Contributors - Ewa Jaraczewska, Jess Bell, Kim Jackson, Lucinda hampton and Tarina van der Stockt
Snapping Hip Syndrome (SHS)[edit | edit source]
There are two types of the Snapping Hip syndromes identified: the external snapping and the internal snapping.
External Snapping Hip[edit | edit source]
External (lateral) snapping hip is a painful condition also known as lateral coxa saltans. It occurs in about 10% of the general population.[1] The external extra-articular factor involves the posterior iliotibial band snapping over the greater trochanter. [2] Second external extra-articular mechanism leading to this condition involves the anterior aspect of the gluteus maximus traveling over the greater trochanter during hip flexion and extension or internal and external rotation of the hip and snapping over the greater trochanter. This may lead to the inflammation of the trochanteric bursa. [2]There are also external intra-articular factors which can lead to development of symptoms characterised this condition. They include labral tears, ligamentum teres tears, loose bodies such as osteochondral fragments, or an instability of the joint.
Internal Snapping Hip[edit | edit source]
Internal extra-articular snapping is caused by the iliopsoas tendon flipping over the iliopectinal eminence or the femoral head and often requires hip flexors contraction. Other proposed extra-articular mechanisms of this condition include:
- accessory iliopsoas tendon slips
- iliopsoas snapping over a ridge at the lesser trochanter
- snapping of the iliofemoral ligament over the femoral head
- subluxation of the long head of the biceps at the ischium
- snapping at the anterior inferior iliac spine.[2]
Intra-articular Snapping Hip[edit | edit source]
The intra-articular factors can lead to development of snapping hip symptom. They include labral tears, ligamentum teres tears, loose bodies such as osteochondral fragments, or joint instability.
Clinically Relevant Anatomy[edit | edit source]
The sensation of snapping may be described as a clicking or catching and may reflect movement of the labral tear or loose body. Any derangement in the interior of the hip joint could theoretically cause coxa saltans.
refers to snapping hip and encompasses three main causes, extra-articular (either external or internal) or intra-articular. The most common form of coxa saltans is the external extra-articular variety which involves either the posterior iliotibial band or the anterior aspect of the gluteus maximus as they travel over the greater trochanter during hip flexion and extension or internal and external rotation. Usually, thickened portions of the posterior iliotibial band or anterior gluteus maximus tendons snap over the greater trochanter causing the catching or “giving way” sensation and inflammation of the trochanteric bursa eliciting pain (Figure 1). Due to the distinct anatomic location and often visible snapping, coxa saltans externa is often easier to diagnose. Coxa saltans externa can be one of the causes of greater trochanteric pain syndrome, which also includes greater trochanteric bursitis and strains or tendonopathy of the hip abductor mechanism.
Mechanism of Injury / Pathological Process
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Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions
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add text here relating to management approaches to the condition
Differential Diagnosis
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add text here relating to the differential diagnosis of this condition
Resources
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add appropriate resources here
References[edit | edit source]
- ↑ Randelli F, Mazzoleni MG, Fioruzzi A, Giai Via A, Calvisi V, Ayeni OR. Surgical interventions for external snapping hip syndrome. Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2386-2393.
- ↑ 2.0 2.1 2.2 Yen YM, Lewis CL, Kim YJ. Understanding and Treating the Snapping Hip. Sports Med Arthrosc Rev. 2015 Dec;23(4):194-9.
