Snapping Hip Syndrome
What is it: Snapping or popping sensation, often painless, that occurs as tendons slide over bony prominences. Most commonly caused by the iliotibial band snapping over the greater trochanter, the iliopsoas tendon sliding over the pectineal eminence of the pelvis or from acetabular labral tears.
How does it present: Patients may present with lateral hip pain in the case of the iliotibial band condition or with groin pain in the iliopsoas and labral conditions. Rotation of the hip usually results in the lateral hip iliotibial band symptoms and iliopsoas symptoms are most often noticed in the groin with hip extension.
Common exam findings: Palpate for snapping over the trochanteric area with hip rotation for iliotibial band symptoms and palpate for snapping over the groin with hip extension for iliopsoas involement. Labral tears may present with decreased range of motion of the hip.
Tests and treatment: Radiographs are typically normal in patients with snapping hip. An MRI arthrogram may be necessary to evaluate for an acetabular labral tear. Treatment of the iliotibial band and iliopsoas symptoms consists of avoiding aggravating activities and stretching and strengthening exercises. Acetabular labral tears are typically corrected surgically.