Popping during external snapping hip (lateral-extra articular), occurs when the thickened posterior aspect of the ITB or the anterior gluteus maximus rubs over the greater trochanter as the hip is extended. Internal snapping hip (medial-extra articular) is usually described by the patient as a snapping or locking of the hip with an audible snap and occurs when the iliopsoas tendon snaps over underlying bony prominences. Almost half of patients with internal snapping hip also have inter-articular pathology. Intra-articular
The causes of intra-articular snapping hip syndrome seem to be broadly similar to those of the extra-articular type, but often include an underlying mechanical problem in the lower extremity. The pain associated with the internal variety tends to be more intense and therefore more debilitating than with the external variety. Intra-articular snapping hip syndrome is often indicative of injury such as a torn acetabular labrum, ligamentum teres tears, loose bodies, articular cartilage damage, or synovial chondromatosis (cartilage formations in the synovial membrane of the joint). Diagnostic
Ultrasound during hip motion may visualize tendon subluxation and any accompanying bursitis when evaluating for iliopsoas involvement in medial extra-articular cases. MRI can sometimes identify intra-articular causes of snapping hip syndrome. Treatment
This condition is usually curable with appropriate treatment, or sometimes it heals spontaneously. If it is painless, there is little cause for concern.
Light aerobic activity (warmup) followed by stretching and strengthening of the proper hamstring, hip flexors, and iliotibial band length is important for reducing recurrences. Conservative measures may resolve the problem in six to eight weeks..
Massage or self-myofascial release may be an effective intervention for external snapping hip syndromes. It is suggested that using soft-tissue modalities to target the iliopsoas for medial extra-articulate snapping hip syndrome and gluteus maximus, tensor fasciae latae, and ITB complex for lateral extras-articulate napping hip syndrome may be effective in treating symptoms of snapping hip syndrome. See also
Femoral acetabular impingement
Iliotibial band syndrome

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