Snapping Hip: Imaging and Treatment

Kenneth S. Lee; Humberto G. Rosas; Jean-Pierre Phancao

doi:10.1055/s-0033-1348095

Seminars in Musculoskeletal Radiology, Inhaltsverzeichnis

Semin Musculoskelet Radiol 2013; 17(03): 286-294
DOI: 10.1055/s-0033-1348095

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Snapping Hip: Imaging and Treatment

Kenneth S. Lee

¹Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

,

Humberto G. Rosas

¹Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

,

Jean-Pierre Phancao

²Department of Radiology, National Orthopedic Imaging Associates, California Pacific Medical Center, San Francisco, California

› Institutsangaben

Abstract

Snapping hip, or coxa saltans, presents as an audible or palpable snapping that occurs around the hip during movement and can be associated with or without pain. The prevalence of snapping hip is estimated to occur in up to 10% of the general population, but it is especially seen in athletes such as dancers, soccer players, weight lifters, and runners. Although the snapping sound can be readily heard, the diagnostic cause may be a clinical challenge. The causes of snapping hip have been divided into two distinct categories: extra-articular and intra-articular. Extra-articular snapping hip can be further subdivided into external and internal causes. Advances in imaging techniques have improved the diagnostic accuracy of the various causes of snapping hip, mainly by providing real-time imaging evaluation of moving structures during the snapping phase. Image-guided treatments have also been useful in the diagnostic work-up of snapping hip given the complexity and multitude of causes of hip pain. We discuss the common and uncommon causes of snapping hip, the advanced imaging techniques that now give us a better understanding of the underlying mechanism, and an image-guided diagnostic and therapeutic algorithm that helps to identify surgical candidates.

Keywords

snapping hip - coxa saltans - iliotibial band - iliopsoas

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Referenzen

References
1 Nunziata A, Blumenfeld I. Snapping hip; note on a variety [article in undetermined language]. Prensa Med Argent 1951; 38 (32) 1997-2001
2 Byrd JW. Evaluation and management of the snapping iliopsoas tendon. Instr Course Lect 2006; 55: 347-355
3 Sammarco GJ. The dancer's hip. Clin Sports Med 1983; 2 (3) 485-498
4 Konczak CR, Ames R. Relief of internal snapping hip syndrome in a marathon runner after chiropractic treatment. J Manipulative Physiol Ther 2005; 28 (1) e1-e7
5 Anderson SA, Keene JS. Results of arthroscopic iliopsoas tendon release in competitive and recreational athletes. Am J Sports Med 2008; 36 (12) 2363-2371
6 Lewis CL. Extra-articular snapping hip: a literature review. Sports Health 2010; 2 (3) 186-190
7 Gruen GS, Scioscia TN, Lowenstein JE. The surgical treatment of internal snapping hip. Am J Sports Med 2002; 30 (4) 607-613
8 Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med 2004; 32 (7) 1668-1674
9 Adler RS, Buly R, Ambrose R, Sculco T. Diagnostic and therapeutic use of sonography-guided iliopsoas peritendinous injections. AJR Am J Roentgenol 2005; 185 (4) 940-943
10 Blankenbaker DG, De Smet AA, Keene JS. Sonography of the iliopsoas tendon and injection of the iliopsoas bursa for diagnosis and management of the painful snapping hip. Skeletal Radiol 2006; 35 (8) 565-571
11 Jacobson JA, Bedi A, Sekiya JK, Blankenbaker DG. Evaluation of the painful athletic hip: imaging options and imaging-guided injections. AJR Am J Roentgenol 2012; 199 (3) 516-524
12 Winston P, Awan R, Cassidy JD, Bleakney RK. Clinical examination and ultrasound of self-reported snapping hip syndrome in elite ballet dancers. Am J Sports Med 2007; 35 (1) 118-126
13 Binnie JF. V. Snapping Hip (Hanche a Ressort; Schnellende Hufte). Ann Surg 1913; 58 (1) 59-66
14 Larsen E, Johansen J. Snapping hip. Acta Orthop Scand 1986; 57 (2) 168-170
15 Dobbs MB, Gordon JE, Luhmann SJ, Szymanski DA, Schoenecker PL. Surgical correction of the snapping iliopsoas tendon in adolescents. J Bone Joint Surg Am 2002; 84-A (3) 420-424
16 Flanum ME, Keene JS, Blankenbaker DG, Desmet AA. Arthroscopic treatment of the painful “internal” snapping hip: results of a new endoscopic technique and imaging protocol. Am J Sports Med 2007; 35 (5) 770-779
17 Hoskins JS, Burd TA, Allen WC. Surgical correction of internal coxa saltans: a 20-year consecutive study. Am J Sports Med 2004; 32 (4) 998-1001
18 Petersilge CA. MR arthrography for evaluation of the acetabular labrum. Skeletal Radiol 2001; 30 (8) 423-430
19 Keene GS, Villar RN. Arthroscopic anatomy of the hip: an in vivo study. Arthroscopy 1994; 10 (4) 392-399
20 Blankenbaker DG, Tuite MJ. The painful hip: new concepts. Skeletal Radiol 2006; 35 (6) 352-370
21 Tatu L, Parratte B, Vuillier F, Diop M, Monnier G. Descriptive anatomy of the femoral portion of the iliopsoas muscle. Anatomical basis of anterior snapping of the hip. Surg Radiol Anat 2001; 23 (6) 371-374
22 Deslandes M, Guillin R, Cardinal E, Hobden R, Bureau NJ. The snapping iliopsoas tendon: new mechanisms using dynamic sonography. AJR Am J Roentgenol 2008; 190 (3) 576-581
23 Armstrong P, Saxton H. Ilio-psoas bursa. Br J Radiol 1972; 45 (535) 493-495
24 Harper MC, Schaberg JE, Allen WC. Primary iliopsoas bursography in the diagnosis of disorders of the hip. Clin Orthop Relat Res 1987; (221) 238-241
25 Lyons JC, Peterson LF. The snapping iliopsoas tendon. Mayo Clin Proc 1984; 59 (5) 327-329
26 Schaberg JE, Harper MC, Allen WC. The snapping hip syndrome. Am J Sports Med 1984; 12 (5) 361-365
27 Pfirrmann CW, Chung CB, Theumann NH, Trudell DJ, Resnick D. Greater trochanter of the hip: attachment of the abductor mechanism and a complex of three bursae—MR imaging and MR bursography in cadavers and MR imaging in asymptomatic volunteers. Radiology 2001; 221 (2) 469-477
28 Allen WC, Cope R. Coxa saltans: the snapping hip revisited. J Am Acad Orthop Surg 1995; 3 (5) 303-308
29 Ilizaliturri Jr VM, Villalobos Jr FE, Chaidez PA, Valero FS, Aguilera JM. Internal snapping hip syndrome: treatment by endoscopic release of the iliopsoas tendon. Arthroscopy 2005; 21 (11) 1375-1380
30 Provencher MT, Hofmeister EP, Muldoon MP. The surgical treatment of external coxa saltans (the snapping hip) by Z-plasty of the iliotibial band. Am J Sports Med 2004; 32 (2) 470-476
31 Cardinal E, Buckwalter KA, Capello WN, Duval N. US of the snapping iliopsoas tendon. Radiology 1996; 198 (2) 521-522
32 Troelsen A, Jacobsen S, Bolvig L, Gelineck J, Rømer L, Søballe K. Ultrasound versus magnetic resonance arthrography in acetabular labral tear diagnostics: a prospective comparison in 20 dysplastic hips. Acta Radiol 2007; 48 (9) 1004-1010
33 Idjadi J, Meislin R. Symptomatic snapping hip: targeted treatment for maximum pain relief. Phys Sportsmed 2004; 32 (1) 25-31
34 Janzen DL, Partridge E, Logan PM, Connell DG, Duncan CP. The snapping hip: clinical and imaging findings in transient subluxation of the iliopsoas tendon. Can Assoc Radiol J 1996; 47 (3) 202-208
35 Johnston CA, Wiley JP, Lindsay DM, Wiseman DA. Iliopsoas bursitis and tendinitis. A review. Sports Med 1998; 25 (4) 271-283
36 Pelsser V, Cardinal E, Hobden R, Aubin B, Lafortune M. Extraarticular snapping hip: sonographic findings. AJR Am J Roentgenol 2001; 176 (1) 67-73
37 Wahl CJ, Warren RF, Adler RS, Hannafin JA, Hansen B. Internal coxa saltans (snapping hip) as a result of overtraining: a report of 3 cases in professional athletes with a review of causes and the role of ultrasound in early diagnosis and management. Am J Sports Med 2004; 32 (5) 1302-1309
38 White RA, Hughes MS, Burd T, Hamann J, Allen WC. A new operative approach in the correction of external coxa saltans: the snapping hip. Am J Sports Med 2004; 32 (6) 1504-1508
39 Larsen E, Gebuhr P. Snapping hip after total hip replacement. A report of four cases. J Bone Joint Surg Am 1988; 70 (6) 919-920
40 Schapira D, Nahir M, Scharf Y. Trochanteric bursitis: a common clinical problem. Arch Phys Med Rehabil 1986; 67 (11) 815-817
41 Segal NA, Felson DT, Torner JC , et al; Multicenter Osteoarthritis Study Group. Greater trochanteric pain syndrome: epidemiology and associated factors. Arch Phys Med Rehabil 2007; 88 (8) 988-992
42 Shbeeb MI, Matteson EL. Trochanteric bursitis (greater trochanter pain syndrome). Mayo Clin Proc 1996; 71 (6) 565-569
43 Gordon EJ. Trochanteric bursitis and tendinitis. Clin Orthop Relat Res 1961; 20: 193-202
44 Tortolani PJ, Carbone JJ, Quartararo LG. Greater trochanteric pain syndrome in patients referred to orthopedic spine specialists. Spine J 2002; 2 (4) 251-254
45 Collée G, Dijkmans BA, Vandenbroucke JP, Rozing PM, Cats A. A clinical epidemiological study in low back pain. Description of two clinical syndromes. Br J Rheumatol 1990; 29 (5) 354-357
46 Strauss EJ, Nho SJ, Kelly BT. Greater trochanteric pain syndrome. Sports Med Arthrosc 2010; 18 (2) 113-119
47 Brignall CG, Stainsby GD. The snapping hip. Treatment by Z-plasty. J Bone Joint Surg Br 1991; 73 (2) 253-254
48 Ilizaliturri Jr VM, Camacho-Galindo J. Endoscopic treatment of snapping hips, iliotibial band, and iliopsoas tendon. Sports Med Arthrosc 2010; 18 (2) 120-127
49 Vaccaro JP, Sauser DD, Beals RK. Iliopsoas bursa imaging: efficacy in depicting abnormal iliopsoas tendon motion in patients with internal snapping hip syndrome. Radiology 1995; 197 (3) 853-856
50 Wettstein M, Jung J, Dienst M. Arthroscopic psoas tenotomy. Arthroscopy 2006; 22 (8) e1-e4
51 Jacobson T, Allen WC. Surgical correction of the snapping iliopsoas tendon. Am J Sports Med 1990; 18 (5) 470-474
52 Taylor GR, Clarke NM. Surgical release of the 'snapping iliopsoas tendon'. J Bone Joint Surg Br 1995; 77 (6) 881-883
53 Czerny C, Hofmann S, Urban M , et al. MR arthrography of the adult acetabular capsular-labral complex: correlation with surgery and anatomy. AJR Am J Roentgenol 1999; 173 (2) 345-349
54 Schmid MR, Nötzli HP, Zanetti M, Wyss TF, Hodler J. Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology 2003; 226 (2) 382-386
55 Daum WJ. Anesthesia update #21. Use of local anesthetic with the hip arthrogram as a diagnostic aid. Orthop Rev 1988; 17 (1) 123-125
56 Tom L, Rosengarten J, Siegel LB. Definitely hip, but not trendy. J Clin Rheumatol 2002; 8 (3) 140-142
57 Klauser AS, Martinoli C, Tagliafico A , et al. Greater trochanteric pain syndrome. Semin Musculoskelet Radiol 2013; 17 (1) 43-48