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认识与治疗弹响髋

Understanding and Treating the Snapping Hip.

作者信息

Yen Yi-Meng, Lewis Cara L, Kim Young-Jo

机构信息

*Division of Sports Medicine †Department of Orthopaedic Surgery, Child and Adult Hip Preservation Program, Boston Children's Hospital, Harvard Medical, School ‡Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences, Sargent College, Boston University, Boston, MA.

出版信息

Sports Med Arthrosc Rev. 2015 Dec;23(4):194-9. doi: 10.1097/JSA.0000000000000095.

Abstract

Snapping hip, or coxa saltans is a palpable or auditory snapping with movement of the hip joint. Extra-articular snapping is divided into external and internal types, and is caused laterally by the iliotibial band and anteriorly by the iliopsoas tendon. Snapping of the iliopsoas usually requires contraction of the hip flexors and may be difficult to distinguish from intra-articular coxa saltans. Ultrasound can be a useful modality to dynamically detect tendon translation during hip movement to support the diagnosis of extra-articular snapping. Coxa saltans is typically treated with conservative measures including anti-inflammatories, stretching, and avoidance of inciting activities. Recalcitrant cases are treated with surgery to lengthen the iliopsoas or the iliotibial band.

摘要

弹响髋,即髋关节跳跃征,是髋关节活动时可触及或听到的弹响。关节外弹响分为外侧型和内侧型,外侧由髂胫束引起,前方由髂腰肌肌腱引起。髂腰肌弹响通常需要髋关节屈肌收缩,可能难以与关节内髋关节跳跃征相鉴别。超声是一种有用的检查方式,可在髋关节活动时动态检测肌腱移位,以辅助诊断关节外弹响。髋关节跳跃征通常采用保守治疗措施,包括使用抗炎药、拉伸以及避免诱发活动。顽固性病例则采用手术治疗,以延长髂腰肌或髂胫束。

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