Snapping Hip and Trochanteric Bursitis
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] and involves the posterior iliotibial band snapping over the greater trochanter. [2] Second extra-articular external mechanism leading to this condition includes 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 the greater trochanter on its way. This may lead to the inflammation of the trochanteric bursa. [2]There are also extra-articular internal 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 mechanism 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]
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]
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Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Management / Interventions
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Differential Diagnosis
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Resources
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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.
