Abstract
We treated a relatively rare case of intra-articular snapping hip caused by an articular
cartilage fragment detached from the deformed femoral head consequent to Perthes disease.
We report the pathology as well as diagnosis and treatment of this case. A 24-year-old
man presented with right coxalgia. He was diagnosed with Perthes disease at a young
age and was treated conservatively. Six months before the patient visited our department,
he started having intense pain accompanied by a clicking sound when he extended and
at the same time externally rotated the right hip joint from a flexed position. Although
a radiogram showed Stulberg class 3 deformity of the femoral head, the joint space
was well preserved and no bone cyst or bone spur formation was seen. Computed tomography
(CT) and magnetic resonance imaging (MRI) showed no abnormal findings inside the femoral
head and in the hip joint. However, when 5 mL of 2% lidocaine hydrochloride was injected
into the hip joint, the snapping phenomenon persisted but the sharp pain was temporarily
resolved.
Arthroscopic finding showed a valve-shaped detachment of articular cartilage in the
anteromedial side of the femoral head. Arthroscopic shaving of the detached fragment
was conducted. The pain and clicking sound accompanying hip joint movement disappeared
postoperatively. Hip joint arthroscopy is useful for the diagnosis and treatment of
intra-articular type snapping hip when the cause of snapping is inside the joint cavity.
Key words
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© 2004 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
