There are 2 main causes for snapping noises or clicking sensations outside the hip. In a small percentage of patients there can be a cause inside the joint, but the majority are due to 2 tendons outside the joint.

1.Iliotibial band

This is a broad tendon which comes from the outer aspect of the pelvis and travels down to the outer aspect of the knee. On its course it travels over the greater trochanter (bony prominence on outer aspect of the thigh bone) and it is here where it can cause problems. It can move from the front to the back of this bone during hip movement, causing a loud snapping noise which is also palpable and occasionally visible. This repetitive snapping can irritate the underlying bursa and lead to trochanteric bursitis.

Precise diagnosis is key and then treatment is usually in the form of physiotherapy to stretch and strengthen the tendon. In very resistant cases surgery can be carried out, but this is rarely necessary.

2. Iliopsoas tendon

The iliopsoas tendon is a strong flexor of the hip joint, which passes over the front of the joint. The tendon can catch over the front of the pelvic brim giving a snapping sensation especially when the hip goes from flexion to the extended position. This is usually more annoying than painful but occasionally the tendon can become inflamed.

Treatment is not frequently necessary, but occasionally if the condition is painful, physiotherapy combined with injection treatment of the tendon may be necessary.