Learning objectives
Discuss the mechanisms in internal snapping hip syndrome (SHS)
Discuss the importance of different imaging modalities in diagnosing internal SHS
Demonstrate a step-by-step dynamic ultrasonography examination and US-guided treatment options in internal SHS
Background
Snaping hip syndrome (SHS),
also known as coxa saltans (or dancer’s hip),
is a clinical condition characterized by an audible or palpable snap in the hip during certain movements,
which may be accompanied by pain.
Internal SHS is the most common type of snapping hip.
It affects predominantly athletes who do repetitive and extreme hip abduction and external rotation movements,
such as ballet dancers,
gymnasts and people doing martial arts.Internal SHS involves the musculotendinous iliopsoas unit.
The most frequently reported mechanism is snapping of the...
Imaging findings OR Procedure Details
1.
IMAGING
PLAIN RADIOGRAPHS
Plain radiographs are the modality dedicated for evaluation of the hip bones (developmental dysplasia) and the joint spaces (osseous intra-articular loose bodies).
Plain radiographs in internal SHS tend to be normal.
[3]
ULTRASOUND (US) EXAMINATION
US is performed with a 5–12-MHz linear transducer.
In some patients with larger body habitus,
the use of a 3–5-MHz curvilinear transducer may be indicated.
Static US evaluation
The patient lies supine on the examination bed with the hip in neutral position (extension and adduction).
Place...
Conclusion
The most efficient radiological algorithm in the assessment of patients with internal SHS is the combination of plain radiography and US.
Dynamic sonography is the only modality that can detect the exact mechanism of the abnormal tendon friction during hip movement and allows correlation with the patient’ symptoms.
Furthermore,
US-guided treatment of the associated tendinopathy or bursitis can provide quick symptomatic improvement.
References
Piechota M,
Maczuch J,
Skupiński J,
Kukawska-Sysio K,
Wawrzynek W.
Internal snapping hip syndrome in dynamic ultrasonography.
J Ultrason.
2016;16(66):296-303.
Ilizaliturri VM,
Camacho-Galindo J.
Endoscopic treatment of snapping hips,
iliotibial band,
and iliopsoas tendon.
Sports Med Arthrosc Rev.
2010;18(2):120-7.
Nolton EC,
Ambegaonkar JP.
Recognizing and Managing Snapping Hip Syndrome in Dancers.
Med Probl Perform Art.
2018;33(4):286-291.
Nathalie J.
Bureau JN.
Sonographic Evaluation of Snapping Hip Syndrome.
J Ultrasound Med.
2013; 32:895–900.
Deslandes M,
Guillin R,
Cardinal E,
Hobden R,
Bureau NJ.
The snapping iliopsoas tendon:...