Symptoms of snapping hip syndrome

There are several possible symptoms that could indicate snapping hip syndrome.

Audible snap

Most commonly, individuals report an audible snap or click in the hip, which may be either painless or painful. The location may be described as lateral or anterior and deep in the groin.

Hip popping out sensations

Occasionally, the phenomenon of a sensation of the hip subluxing or going out of place is felf and is associated with the iliotibial band.

Groin pain

Patients reporting anterior groin pain usually note that the pain is dull or aching in nature and is exacerbated by extension of the flexed, abducted, and externally rotated hip. The pain and snapping may subside with decreased activity and rest. The duration of symptoms at presentation is several months or years rather than days or weeks.

Diagnosis of snapping hip syndrome

Inspection

Every doctor should first examine the gait for abnormalities in biomechanics. Normally if associated iliopsoas tendonitis (inflammation of the tendons) is present, the patient may have a flexed knee. Then joint should be observed as well as the production of the snapping. Some symptoms could be mild and trivial, but external snapping hip syndrome associated with subluxation of the iliotibial band over the greater trochanter may be dramatic and appear as if the patient is subluxing his or her hip.

Palpation

Palpation should definitely be the next step in diagnosis of this condition. Those with external snapping hip syndrome may have tenderness over the proximal iliotibial band, lateral margin of the gluteus maximus. Patients with internal type of the condition may demonstrate an anterior pelvic tilt. Snapping occurs with extension of the flexed, abducted, and externally rotated hip.

Functional testing

There are several functional testings available for the proper diagnosis. External type of the condition is often reproduced with passive internal and external rotation of the hip with the patient in the side-lying position. Internal snapping hip syndrome symptoms can be reproduced with extension of the flexed (30°), abducted, and externally rotated hip.

Imaging diagnostics: X-ray, MRI, ultrasound…

An X-Ray is usually taken to confirm that there is no bony problem around the hip joint, but there is one problem - X-Rays are almost always normal with snapping hip syndrome. If the cause of snapping hip syndrome is thought to be due to a tear of the cartilage within the hip joint, an MRI may be obtained to look for evidence of this problem which is difficult to diagnose.

Ultrasound is a useful, noninvasive diagnostic adjunct because it may demonstrate changes in anatomy and provide an assessment of function. The great benefit of the ultrasound in the case of snapping hip syndrome is the ability to visualize the iliopsoas tendon to provide a directed injection of anesthetic and possible subsequent pain relief.

Lab Studies

There are no specific laboratory studies. For an individual in whom the hip pain is of an unclear origin or with imaging study results suggestive of other pathology, specific consideration should be given for diagnostic laboratory studies at that time.