Snapping Hip - A descriptive term!

Introduction

There are many causes of clicking snapping and popping around the hip. Much like "Anterior Knee Pain" we must avoid using this term as a diagnosis.

Extra-articular Causes

Lateral extra articular snapping - Trochanteric Bursitis

The more common lateral extra articular type of snapping hip syndrome occurs when the iliotibial band, tensor fascia lata, or gluteus medius tendon slides back and forth across the greater trochanter. This normal action becomes a snapping hip syndrome when one of these connective tissue bands thickens and catches with motion. The underlying bursa may also become inflamed, causing a painful external snapping hip syndrome.

Medial extra-articular snapping - Psoas Bursitis

Less commonly, the iliopsoas tendon catches on the anterior inferior iliac spine (AIIS), the lesser trochanter, or the iliopectineal ridge during hip extension, as the tendon moves from an anterior lateral (front, side) to a posterior medial (back, middle) position. With overuse, the resultant friction may eventually cause painful symptoms, resulting in muscle trauma, bursitis, or inflammation in the area.

Intra-articular Causes

Any mechanical derangement in the hip can cause friction and disrupt the normally smooth movement of the hip joint:-

Acetabular labral tears
Recurrent hip subluxation
Loose bodies

Ligamentum teres tears
Avulsion fractures
Articular cartilage damage
Synovial chondromatosis

Fragmentation of the head in AVN