Hip Internal Snapping Hip Syndrome

Pain in the groin with hip range of motion may be attributable to the iliopsoas tendon (or hip flexor). The tendon normally glides smoothly across pelvis bone with hip motion.

Patients generally present with pain in the groin region. The pain can be sharp, dull, aching, or burning in nature. Patients often report a snapping sensation that may be audible.

As the iliopsoas tendon travels from the pelvis to its attachment on the femur bone, it may develop friction as it glides across the pelvic bone in the groin. The diagnosis is made with a careful clinical examination by your orthopedic surgeon. Radiographs (or x-rays) are helpful in ruling out other possible causes of hip pain. You may be recommended to undergo an MRI scan. Fluoroscopy with a contrast injection into the tendon or a plain ultrasound of may sometimes be utilized to visualize the snapping of the tendon.

Treatments usually start with anti-inflammatory medications and physical therapy. Your doctor may recommend an injection of pain medication such as cortisone and/or lidocaine into the hip flexor tendon sheath. This may be performed with ultrasound guidance. This can also be useful as a diagnostic test to rule out other causes of “hip pain” such as lower back nerve radiating pain.

Surgery may be recommended for those patients who have tried the above non-surgical treatments and who still have persistent symptoms. The majority of surgeries are outpatient and can be performed using an arthroscope, or minimally invasive camera procedure. In some cases, an open procedure must be performed to successfully treat the condition. Time for full recovery is multi-factorial and depends on the etiology of your hip pain as well as the chronicity of the pain. Diligent physical therapy is paramount for a successful outcome.