Many people with snapping hip syndrome feel as though the ball of their ball-and-socket hip joint is coming out of position, a so-called hip subluxation. This is very rarely associated with snapping hip syndrome, and usually caused be severe traumatic injuries.
Causes of Snapping Hip Syndrome
- Iliotibial Band Syndrome
The iliotibial band is a thick, wide tendon over the outside of the hip joint. The most common cause of snapping hip syndrome is when the iliotibial band (or "IT band") snaps over the greater trochanter (the bony prominence over the outside of the hip joint). If this is the cause of a snapping hip, patients may develop hip bursitis from the irritation of the bursa in this region.
- Iliopsoas Tendon Snap
The iliopsoas tendon is the primary hip flexor muscle, and the tendon of this muscle passes just in front of the hip joint. The iliopsoas tendon can catch on a bony prominence of the pelvis and cause a snap when the hip is flexed. Usually when the iliopsoas tendon is the cause of snapping hip syndrome, patients have no problems, but may find the snapping annoying.
- Hip Labral Tear
The least common cause of snapping hip syndrome is a tear of the cartilage within the hip joint. If there is a loose flap of cartilage catching within the joint, this may cause a snapping sensation when the hip is moved. This cause of snapping hip syndrome typically causes a snapping sensation, but rarely an audible "pop." This cause of snapping hip syndrome may also cause an unsteady feeling, and patients may grab for support when the hip snaps.
An x-ray is usually taken to confirm that there is no bone problem around the hip joint, but these tests are almost always normal. If the cause of snapping hip syndrome is thought to be due to a cartilage or labral tear within the hip joint, an MRI may be obtained to look for evidence of this difficult to diagnose problem.
Treatment of Snapping Hip SyndromeTreatment of snapping hip depends most significantly on the cause of the problem. Once the correct cause has been identified, appropriate treatment can begin. Usually, treatment begins with simple steps, as seldom does a snapping hip require immediate intervention. Often an oral anti-inflammatory medication, or possibly a cortisone injection will help control inflammation if this is contributing to the problem. Physical therapy may be useful for stretching out the muscles and tendons that cause a snapping hip and may help prevent the problem.
Surgery is rarely necessary, and reserved for patients who have severe symptoms for long periods of time with adequate trial of non-operative treatments. If this is the case, surgery to relax the tendons, or remove the cartilage tear may help with the symptoms of a snapping hip. Often hip arthroscopy can be used for the surgical treatment of these hip problems.
Allen WC and Cope R "Coxa Saltans: The Snapping Hip Revisited" J Am Acad Orthop Surg October 1995 ; 3:303-308.