Snapping Hip

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Snapping hip syndrome (coxa saltans) is a snapping, clicking, or popping sensation at the hip during movement. Three main types exist: external — the IT band snapping over the greater trochanter; internal — the iliopsoas tendon snapping over the iliopectineal eminence or femoral head; and intra-articular — a loose body, cartilage flap, or labral tear inside the joint causing snapping.

The external and internal types are common in dancers and gymnasts and are often painless. When the snap causes pain, or when intra-articular pathology is suspected, further evaluation and treatment are warranted.

The snap can often be reproduced by the examiner. External snapping is visible and palpable at the lateral hip; internal snapping is felt at the groin and may be heard. Dynamic ultrasound is the most useful imaging tool — it visualizes the tendon snapping in real time. MR arthrography evaluates for intra-articular causes when suspected.

1. Corticosteroid injection

   Guided injection into the iliopsoas bursa or trochanteric bursa is effective for painful snapping that does not respond to stretching.

Surgery is rarely needed. When snapping is painful and refractory to conservative care over 6+ months, endoscopic tendon lengthening or release is considered.

External patient-education references and related OSI pages for additional background:

• Britannica — Hip (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language