All of the following are possible contributing sites to coxa saltans except:

• A. Iliopsoas over the femoral head
• B. Proximal lesser trochanter
• C. Iliopectineal eminence
• D. Iliotibial band over the posterior inferior iliac spine

Answer: (D)

Coxa saltans, commonly referred to as "snapping hip," can be due to various structures around the hip joint that may cause a snapping sensation when they move over bony prominences. The iliopsoas tendon, which runs over the femoral head, is one well-known contributor to this phenomenon, particularly in several hip flexor-related conditions. The proximal lesser trochanter and the iliopectineal eminence are also recognized contributing sites, as they relate to where tendons and muscles may interact with the bony architecture during hip movements.

In contrast, the iliotibial band primarily influences knee stability and is more associated with lateral hip conditions rather than the specific snapping caused by structures over the pelvis or femoral head. When the iliotibial band interacts with the greater trochanter (on the lateral side of the hip) as the hip moves, it may produce lateral snapping sensations or symptoms, but it does not typically create the same type of "snapping hip" symptoms associated with structures noted in the other options. Thus, it’s clear that the iliotibial band over the posterior inferior iliac spine does not contribute to coxa saltans in the way that the other sites do.