Asymptomatic snapping is common, with a prevalence of 5–10% in the general population. When associated with pain or discomfort, it is termed as snapping hip syndrome (SHS). It can be broadly divided into two types: (1) external and (2) internal. External SHS (ESHS) is due to the friction between the iliotibial band and the greater trochanter on the lateral aspect of the hip, whereas internal SHS (ISHS) is due to the interaction between the iliopsoas tendon and the structures it crosses in the anterior aspect of the hip along its course to the lesser trochanter. Clinical examination alone is sufficient to clinch the diagnosis. However, other imaging tests are needed to rule out concomitant or underlying pathologies. Conservative management is the mainstay of the treatment. Surgery is reserved as the last resort. Open and endoscopic procedures have been described for both types. In ESHS, surgical outcomes and complication rates are comparable between open and endoscopic techniques. But, when it comes to ISHS, endoscopic techniques have delivered better outcomes with significantly fewer complications.

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Snapping Hip: Internal and External

  • Deven R. Kuruwa,
  • Munis Ashraf,
  • Prakash George

摘要

Asymptomatic snapping is common, with a prevalence of 5–10% in the general population. When associated with pain or discomfort, it is termed as snapping hip syndrome (SHS). It can be broadly divided into two types: (1) external and (2) internal. External SHS (ESHS) is due to the friction between the iliotibial band and the greater trochanter on the lateral aspect of the hip, whereas internal SHS (ISHS) is due to the interaction between the iliopsoas tendon and the structures it crosses in the anterior aspect of the hip along its course to the lesser trochanter. Clinical examination alone is sufficient to clinch the diagnosis. However, other imaging tests are needed to rule out concomitant or underlying pathologies. Conservative management is the mainstay of the treatment. Surgery is reserved as the last resort. Open and endoscopic procedures have been described for both types. In ESHS, surgical outcomes and complication rates are comparable between open and endoscopic techniques. But, when it comes to ISHS, endoscopic techniques have delivered better outcomes with significantly fewer complications.