The ball and socket joint in the hip is formed by the femoral head (ball) and the cup-shaped cavity of the pelvis known as the acetabulum (socket). These bony components are kept stable by the labrum–strong, fibrous cartilage that covers the acetabulum–and the ligaments and tendons that surround the hip and control movement. Snapping hip syndrome is a condition in which movement of the hip generates a snapping sound that can be both heard and felt. This effect can be reproduced by running, walking, swinging your leg, or getting up from the chair. This snapping sensation is caused by the movement of soft tissues over a bony protrusion in the hip and can occur in the front, back or sides of the hip.
Snapping hip syndrome is most commonly the result of muscle and tendon tightness in the soft tissues around the hip. Individuals who participate in sports and extracurricular activities that require bending at the hip are more likely to experience snapping hip; consequently, dancers are especially vulnerable to the condition. Young athletes are also more likely to suffer from snapping hip syndrome, because adolescent growth patterns generally cause tightness in the soft tissue structures of the hip. In rarer instances, the snapping can be caused by a torn or loose piece of cartilage, which can ultimately lodge in the joint and cause a “locked” hip.
The most common form of snapping hip syndrome is located in the front of the hip where the hip flexor (iliopsoas tendon) snaps over the front of the hip. This is known as internal snapping hip (coxa saltans) and is very common in young females. Snapping is also common on the outside of the hip and is the result of the iliotibial band (soft tissue) snapping as it passes over the greater trochanter (bony prominence).
The most common symptom of snapping hip syndrome is an audible, tangible snapping sensation as the hip flexes and extends. There is sometimes pain and weakness associated with the snapping, but not always. Even without pain, however, this sensation can be very unnerving and will ultimately lead to larger issues if it is left untreated.
Diagnosis and Treatment
In order to diagnose snapping hip syndrome, a physician will complete a thorough physical examination accompanied by a detailed family and medical history. During this examination, you will likely be asked to reproduce the snapping sound by moving your hip along different plans and in different directions. Your physician may also order diagnostic imaging tests to better visualize the anatomy of your hip; x-ray images will help them visualize the bony prominences that may be causing the snapping sensation, while magnetic resonance imaging (MRI) may be used to visualize the soft tissues that are at fault.
If you have been diagnosed with snapping hip syndrome, your physician will likely first recommend a conservative course of treatment. This could include stretching, rest, activity modification, physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and steroid injections. Steroid injections are commonly done with ultrasound to better visualize the structures. If you fail conservative treatment, you can elect to move forward with surgical intervention. Surgery for snapping hip syndrome is generally done arthroscopically and requires your physician to release the soft tissues or shave down the bony prominences that are causing the snapping sensation.