Which leg maneuver should be performed to elicit anterior iliopsoas snapping hip on ultrasound?

The answer is movement of the leg from flexion, abduction, and external rotation to extension.Snapping hip presents as #hip pain accompanied by an audible and/or palpable clicking or snapping during #joint motion or walking. This finding in the anterior hip occurs when the iliopsoas tendon and #muscle snap over the iliopectineal eminence of the hip when moving the #leg from #flexion to extension.On ultrasound, the transducer should be placed short axis to the #iliopsoas where the tendon has a close relationship with the #bony surface of the iliopectineal eminence. This #bone can be identified by its vshaped appearance, just proximal to the #hip_joint.

When flexion, abduction, and external rotation are performed, the iliopsoas #tendon shifts laterally and anteriorly. When the leg is then straightened, it causes the tendon to move abruptly in a medial and posterior direction allowing the snapping sensation to be captured on realtime dynamic imaging. You should correlate the timing of the audible and/or palpable #snap with the tendon snap that is visible on ultrasound.

If no snap is seen, ask the patient to generate the hip movement that produces the snapping sensation and attempt to capture it. It can be challenging to perform some leg maneuvers with the #transducer over the area of an interest. If the transducer is blocking the leg movement from being performed, move the transducer slightly out of the way and angle it towards the #target.

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