Coxa Saltans: Iliopsoas Snapping and Tendonitis

Abstract

Coxa saltans, or snapping hip, is a clinical condition characterized by an audible or palpable snapping sensation that may be heard during movement of the hip joint. Snapping hip has multiple etiologies and has been classified based on the anatomic structure that is the cause of the snapping phenomenon. Two main snapping hip categories have been recognized (Extra-articular and Intraarticular). Extra-articular snapping may be further divided into external snapping and internal snapping. External snapping hip is most commonly attributed to the iliotibial band moving over the greater trochanter during hip movements in flexion, extension, and external or internal rotation. Internal snapping hip most commonly occurs as the iliopsoas tendon snaps over underlying bony prominences, such as the iliopectineal eminence. The snapping sensation can closely mimic intraarticular pathology and can cause irritation and inflammation of the tendon, since they both originate from the anterior portion of the hip. Meticulous physical examination and imaging can differentiate the origin of the snapping. Treatment options must be chosen on an individual patient basis (conservative versus surgical).