The most common symptom alarming the patient is pain (coxalgia). The seat of pain is typically the groin. Pain often spreads along the anterior face of the thigh as far as the knee.
The manner of onset varies with the pathology that causes it. A slow beginning of pain with gradual worsening in an elderly patient suggests the onset of coxarthrosis, while acute pain in a young patient, on the other hand, points to necrosis of the femur head or a femoroacetabular impingement.
Pain caused by the knee joint may be solicited by loading (ambulation) or passive mobilization by the examiner through full excursion of the joint. A pain accompanied by a click or triggered by local pressure, on the other hand, may indicate a problem with the soft tissues surrounding the joint, such as tendons, muscles and bursae.
Pain may often be accompanied by limping, in this case called an “antalgic limp”,caused by the patient’s efforts to avoid pain by minimizing the time the leg with the painful hip rests on the ground. Such effort produces asymmetry of gait because the “sick” limb is in contact with the ground for less time than the healthy one.
Less common is rigidity, often due to severe consumption of the articular surface and the onset of calcification diminishing articular excursion.
- 1. Flanum ME, Keene JS, Blankenbaker DG, DeSmet AA. Arthroscopic treatment of the painful “internal” snapping hip. Am J Sport Med 35: 770-778, 2007
- Ilizaliturri VM, Chaidez C, Villegas P, Briseno A, Camacho-Galindo J. Prospective randomized study of 2 different techniques for endoscopic iliopsoas tendon release in the treatment of internal snapping hip syndrome. Arthroscopy 25, 2: 159-163, 2009