Coxa saltans belongs to the orthopaedic diseases. The disease is relatively rare. There is the “external”, also “external”, coxa saltans, where the tractus iliotibialis jumps over the greater trochanter of the femur.
On the other hand there is the less frequently occurring “inner”, also “internal” coxa saltans. Here the tendon of the psoas muscle is affected. The age of manifestation is 9 to 14 years, although it is often only diagnosed in middle age (40 years). About 5% of the population is affected by a snapped hip. It is believed to be more common in women than in men.
Causes
To understand the cause, one must first become aware of the anatomy of the thigh: The thigh has a thick connective tissue called the fascia lata. On the outside of the thigh, this fibrous layer is several centimetres wide. It spans the hip joint like a plate.
This area is called tractus iliotibialis. Normally, the tractus iliotibialis should slide smoothly over the greater trochanter (the large rolling mound at the neck of the thigh bone where the gluteal muscles have their attachment). In the “outer coxa saltans”, the tractus glides over at too short a distance.
As a result, a part of the fibrous tractus iliotibialis can get caught on the greater trochanter in the hip joint during flexion or extension. Shortly after getting stuck, there is a backward skip over the greater trochanter if the tension on the tendon is too great. This is where the name “snapping hip” comes from, since an audible and palpable snapping can occur.
Sometimes this also occurs during normal walking. Reasons for the tendon getting stuck can be bursitis. Likewise, unequal length of legs and the strain that comes with it can cause a “jumping hip”.
Muscular imbalances, which occur mainly in athletes, can also be the cause of a jumping hip. Often, however, the reason cannot be found out, so that the therapy is also difficult. With the inner coxa saltans, the tendon of the psoas muscle, which runs over the hip joint at the front, causes irritation at the edge of the socket of the femur or at the head of the femur. A coxa saltans can also be triggered by an inflammation of the bursa.
Risk factors
Excessive exercise can be a risk factor for the development of a snapping hip, as certain movements are often repeated depending on the type of sport. Examples of “high-risk sports” include ballet, gymnastics, horse riding and football. Weightlifting or jogging are also included, as these sports are usually accompanied by extreme thickening of the tendons in the hip region.
Symptoms
Patients usually find the snap-over very unpleasant. It usually causes moderate to moderate pain due to irritation of the affected area. Often the pain stops again when the patient is at rest and has limited activity.
Overall, the movement of the hip is limited: internal rotation is not fully possible and the leg can only be spread with difficulty. So every step experiences a short blockage. With pronounced forms, the affected person may begin to limp. In addition, there may be swelling in the lateral area of the hip.
