snapping iliopsoas tendon

Snapping iliopsoas tendon is one of the external causes of a medial snapping hip and occurs when a portion of the iliopsoas tendon moves abruptly onto the superior pubic ramus leading to a snap.

Epidemiology

Most commonly affects athletes with repeated hip abduction (e.g. dancing, gymnastics, martial arts) .

Pathology

This typically is a result of a rapid relocation of a portion of the iliopsoas tendon, transiently entrapped anterior and lateral to the portion of the iliacus muscle belly during flexion external rotation and abduction of the femur, onto the superior pubic ramus during returning into the neutral position or a bifid tendon moving around itself.

Other rare known causes of snapping iliopsoas tendon is snapping over an adjacent paralabral cyst or across the anterior inferior iliac spine (AIIS) in the frog leg position .

Radiographic features

Ultrasound

Dynamic ultrasound examination while doing a maneuver to reproduce the snap is often diagnostic .

Treatment and prognosis

This phenomenon is present in approximately 40% of the asymptomatic population, and by itself does not require investigation, although in repetitive this condition can result in iliopsoas tendinopathy .

Iliopsoas tendon release or fasciotomy have been used to alleviate pain in those who fail conservative treatment measures.

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