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Snapping Hip

‘Snapping hip’ syndrome can be caused by injuries both within the joint and outside the joint. The condition is not well defined. Causes are as follows.

1. Lateral snapping: the thickened iliotibial band riding over the greater trochanter or a thickened bursa.

2. Anterior deep snapping:

• the iliopsoas tendon passing over the anterior aspect of the hip joint (the iliopectineal eminence) and through the iliopectineal bursa, which may be inflamed and thickened.
• the iliofemoral ligament passing the femoral head.
• intra-articular pathology: loose bodies, labrum tears, etc., inside the joint.

The snapping associated with hip motions is the reason for complaint. Occasionally pain is associated with this syndrome, which is predominantly seen in women. Tenderness and pain may be an indication for more active therapy. The biomechanical reasons for the snapping should be investigated. Occasionally, surgical treatment is indicated in patients with continued symptoms.

The snapping caused by the iliopsoas tendon when it rides over the iliopectineal eminence and through the bursa occurs when the hip is abducted (away from the body) and externally rotated. Iliopsoas
bursography can be carried out to demonstrate bursitis. An MRI scan can be used to substantiate this finding. Surgical treatment in these cases includes lengthening or sectioning of the iliopsoas tendon with
reasonably good effects, and/or excision of a thickened bursa.

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