External Snapping Hip

Abstract

External snapping hip is caused by the iliotibial (IT) band moving over the greater trochanter. In contrast, internal snapping hip is typically caused by the iliopsoas tendon moving over either the femoral head or the iliopectineal eminence. These are both extra-articular causes of snapping hip; there are also intra-articular causes. The diagnosis of external snapping hip is typically clinical, with many patients able to demonstrate the snapping upon request. Treatment should consist of physical therapy and IT band stretching. Injections of corticosteroid may be helpful in the cases of painful snapping hip, typically caused by associated trochanteric bursitis. If these interventions fail, surgical windowing or lengthening of the IT band is the next option. Hip abduction weakness or a Trendelenburg gait are possible complications of this operation.

What anatomic structures are involved in external snapping hip?	Iliotibial band snapping over greater trochanter
Is external snapping hip usually painful?	No
Are radiographic and MRI findings typically normal in this condition?	Yes
What test helps diagnose a tight tensor fascia lata?	Ober’s test
Is nonoperative treatment successful in most cases?	Yes
What is the surgical treatment for painful external snapping hip that fails nonoperative treatment?	IT band lengthening (or windowing)
What is a potential risk specific to this operation?	Trendelenburg gait