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BACKGROUND: Although snapping hip syndrome is commonly reported in ballet dancers, the prevalence, impact, and underlying mechanism of this condition have not been formally studied within a cohort of dancers. PURPOSE: To determine the prevalence, associated factors, and mechanisms of snapping hip and to investigate self-reported snapping with physical and ultrasound examination. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A snapping hip questionnaire was completed by 87 unselected elite ballet dancers at 2 institutions. Twenty-six of the dancers (50 hips) who were able to voluntarily snap their hips were selected from this group for further physical examination by 2 clinicians to determine whether there was a palpable snap, and each underwent an ultrasound examination of his or her hips. RESULTS: Ninety-one percent of dancers reported snapping hip, of which most (80%) had bilateral symptoms. Fifty-eight percent had pain associated with the snap, and 7% had taken time off dance because of this condition. Sixty percent of the dancers could voluntarily snap their hip. One or more of 3 dance movements elicited the snapping in 81%. The clinicians could palpate 46 of the 50 self-reported snapping hips. Ultrasound showed a snapping iliopsoas tendon in 59% of the hips and the iliotibial band snapping in 4%. In one third of cases, ultrasound was not helpful in identifying the cause of the snapping. CONCLUSION: Snapping hip is extremely common in ballet dancers. Some dancers have significant pain, yet many are asymptomatic. Self-reported snapping is likely to be palpable by the clinician. Iliotibial band snapping is evident by physical examination and ultrasound. Iliopsoas snapping was most common and required ultrasonic confirmation.
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