It’s review time! Orthopedic review, that is! Snapping hip syndrome…also called coxa saltans or dancer’s hip. It is the audible or palpable popping in the hip that occurs with movement. It’s classified based on the origin of the snapping. In the past, extra-articular and intra-articular were used to define the origin, but we don’t like to use the term intra-articular snapping hip anymore. We know more about intra-articular pathology now, so it is usually defined more specifically by imaging. Extra-articular causes are further subdivided into internal and external varieties which are based on the location of the snapping.
External snapping hip is more common and involves the lateral hip. Most commonly, it is attributed to the iliotibial band moving over the greater trochanter during flexion, extension, and external or internal rotation. External snapping can also be caused by the proximal hamstring tendon rolling over the ischial tuberosity, either the fascia lata or the anterior aspect of the gluteus maximus rolling over the greater trochanter, and the psoas tendon rolling over the medial fibers of the iliacus muscle. A combo is also possible – thickening of both the posterior iliotibial band and anterior gluteus maximus, which snap over the greater trochanter at the same time.
Internal snapping hip is less common. When it occurs, it typically involves the iliopsoas tendon. The tendon snaps over underlying bony prominences, such as the iliopectinal eminence or the anterior aspect of the femoral head. It could also be caused by paralabral cysts and partial or complete bifurcation of the iliopsoas tendon. This can mimic intra-articular pathology because both originate from the anterior hip area. Close physical exam and imaging can differentiate the two.
Musick SR, Bhimji SS. Snapping Hip Syndrome. [Updated 2017 Oct 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448200/