Snapping Hip Syndrome Flashcards
Definition/Description
Snapping Hip Syndrome (SHS), also known as Coxa Saltans, is a condition that is characterized by a snapping sensation, and/or audible “snap” or “click” noise, in or around the hip when it is in motion. There are various causes for snapping hip syndrome, which can be further classified as external, internal, or intra-articular in origin
External (most common)
Iliotibial band (or “IT band”) snapping over the greater trochanter of the femur. Internal
Iliopsoas tendon snapping over a bony prominence of the pelvis.
Intra-articular (least common)
Usually due to a tear of the cartilage and/or loose body within the hip joint that may also cause the hip to “lock up”.
Characteristics/Clinical Presentation
People with external SHS will usually have a gradual onset of snapping or pain located laterally over the greater trochanter. The external type is not associated with a traumatic event, but there can be a minor MOI.
The clinical presentation is often easily observable by watching and listening for snap as the patient actively flexes and extends the hip. These patients may describe a sense that the hip is dislocating.
People with external SHS may also have coxa vara, fibrotic scar tissue, a prominent greater trochanter, smaller lateral pelvic width, or a past surgery for anterolateral knee instability.
Internal
Internal SHS also has a gradual onset, not usually associated with a traumatic event.These patients describe a painful sensation coming from deep within the anterior groin as they move their leg from flexion into extension or external rotation. The snapping movement can produce an auditory clunk or click.
Intra-articular
Patients with Intra-articular SHS report a sudden onset of snapping or clicking from an injury or traumatic event to the hip capsule. The sources of this snapping can come from intracapsular lesions, loose bodies settling in the acetabular fovea or synovial folds, a torn acetabular labrum, synovial chondromatosis, or a history of habitual hip dislocation in children or idiopathic recurrent subluxation.
Physical Therapy Management
Andres et al conducted a systematic review of interventions for tendonitis, and determined that eccentric strengthening exercises showed the greatest value in decreasing pain and increasing function, when compared to other physical therapy interventions.
A case study has been published which documents the complete resolution of pain in a case of lateral coxa saltans. Myofascial release of the tensor fascia latae, gluteus medius, and gluteus maximus, and adductor musculature was performed, and the patient was prescribed a general stabilization and strengthening program focusing on the abductor musculature.[
