Snapping Hip Syndrome Essay

When starting an examination for suspected Snapping Hip Syndrome one should first look and listen for the snap. External there will be visible snapping in the hip while internal usually does not show, but can be felt during palpation. Internal is also more likely to be an audible snapping noise while external is a quieter noise usually not detected. For palpation start at the greater trochanter as the hip is actively flexed. If by applying pressure the snapping stops then it is external Snapping Hip Syndrome. To confirm this diagnosis perform the Ober test looking for tightness in the tensor fascia lata and limited hip adduction when hip is held in extension. If these tests are negative continue the physical examination with passively moving hip from flexed and externally rotated position to an extended and internally rotated position looking to see if snapping
In the article “Snapping Hip (Coxa Saltans)” by Mark Karadesheh and Patrick McCulloch they recommend for radiographs a view of the AP pelvis/hip. This is used to rule-out synovial chondromatosis. For ultrasound, during dynamic movement, snapping of tendons or bands can be viewed for external or internal Snapping Hip Syndrome. For external ultrasound can be used to localize a diagnostic challenge injection into the trochanteric bursa, while for internal the iliopsoas sheath, and the intra-articular space. MRI’s can be used to rule out intra-articular pathology and can show inflamed bursas. Lastly, the use of iliopsoas bursography are to view the iliopsoas tendon under fluoroscopy after the bursa was injected with contrast dye. It is also used for therapeutic injections after diagnosis of Snapping Hip Syndrome is confirmed. These scans are usually only used when there is a suspected intra-articular syndrome or there is thought to be other injuries involved (Mark Karadesheh Reference