What is the diagnosis and treatment for internal snapping hip syndrome (coxa saltans interna)?

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Differential Diagnosis for Internal Snapping Pelvis

  • Single most likely diagnosis
    • Coccygeal subluxation or fracture: This is the most likely diagnosis due to the internal snapping sound, which can occur when there is a disruption in the coccyx or its surrounding ligaments, leading to abnormal movement and the characteristic snapping sound.
  • Other Likely diagnoses
    • Iliopsoas tendonitis or snapping hip syndrome: This condition occurs when the iliopsoas tendon snaps over the iliopectineal eminence or the femoral head, producing an audible snap. It's a common cause of internal snapping sounds in the pelvic area.
    • Osteitis pubis: This is an inflammatory condition affecting the pubic symphysis, which can cause pain and snapping sounds due to instability or inflammation of the joint.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Pelvic fracture: Although less common, a pelvic fracture can cause an internal snapping sound, especially if there is a fracture of the pubic rami or the sacrum. Missing this diagnosis could lead to significant morbidity or mortality.
    • Cauda equina syndrome: This is a rare but serious condition where the nerves in the spinal canal are compressed, which can cause a range of symptoms including pain, numbness, and weakness in the lower extremities. An internal snapping sound could potentially be a presenting symptom of this condition.
  • Rare diagnoses
    • Synovial chondromatosis of the hip: This is a rare condition where cartilaginous nodules form in the synovial membrane of the hip joint, which can cause snapping or clicking sounds.
    • Intra-articular loose body: A loose body within the hip joint, such as a fragment of bone or cartilage, can cause snapping or clicking sounds as it moves within the joint.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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