Successful Surgical Intervention for External Snapping Hip Syndrome in a Middle-Aged Woman

Snapping hip syndrome is a condition characterized by a palpable or audible snap in the hip, particularly during movement. It can be asymptomatic and is categorized into external (lateral) and internal (medial) types. External snapping hip syndrome (ESHS), often due to the iliotibial band (ITB) flipping over the greater trochanter, is more common and usually responds to conservative treatments.

We present a case of a 44-year-old woman who experienced a sensation of hip dislocation and lateral pain in her right hip in the last 3 years which worsened over time. Her symptoms, including pain triggered by hip flexion and external rotation, were not alleviated by different conservative treatments. Imaging studies, including ultrasound and MRI, did not reveal a thickened ITB or bursa abnormalities. Subsequently, the patient underwent ITB release procedure. A longitudinal incision and perpendicular cuts were made on the ITB in the lateral decubitus position, and the trochanteric bursa was resected. Postoperatively, the patient was allowed weight-bearing with crutches for 1-2 weeks. The patient improved significantly and returned to normal activities within eight weeks.

This case highlights an atypical presentation of ESHS in a patient outside the typical demographic. A clinical diagnosis was made after unrevealing imaging and ruling out common causes of lateral hip pain. After failed conservative management, surgical treatment resulted in complete symptom resolution and no early complications. These findings support considering ESHS in patients with lateral hip pain across age and activity levels and demonstrate the effectiveness of operative management when conservative treatment fails.