What is transient synovitis of the hip?

Transient synovitis (sin-oh-vie-tis), commonly called irritable hip, is the most common cause of limping in children. It is due to inflammation (swelling) of the lining of the hip joint. In most cases of irritable hip, your child will have recently recovered from a viral infection.

What is the difference between transient synovitis and septic arthritis?

Whereas transient synovitis is self-limiting, septic arthritis needs urgent decompression of the hip and intravenous antibiotics. Delays in treatment increase the risk of complications, including osteonecrosis of the capital femoral epiphysis, osteomyelitis, chondrolysis, systemic sepsis and secondary osteoarthritis.

How is transient synovitis assessed?

The most sensitive test for transient synovitis is the log roll, in which the patient lies supine and the examiner gently rolls the involved limb from side to side. This may detect involuntary muscle guarding of one side when compared to the other side.

What are symptoms of transient synovitis?

Transient toxic synovitis causes pain in the hip, thigh, groin or knee on the affected side. There may be a limp (or abnormal crawling in infants) with or without pain. In small infants, there can be unexplained crying while changing a diaper. The condition is nearly always limited to one side.

Does transient synovitis show on xray?

In transient synovitis of the hip, a 2-view standard x-ray examination (anterior–posterior and frog-leg lateral views) yields a negative outcome or is only indicative of joint effusion [1,5].

Is ESR raised in transient synovitis?

The following studies may be indicated in transient synovitis (TS): CBC count: The white blood cell (WBC) count may be slightly elevated. The erythrocyte sedimentation rate (ESR) may be slightly elevated.

Can transient synovitis affect other joints?

It usually only affects one hip, but it’s possible for swelling and inflammation to spread to other joints.

Can synovitis be caused by trauma?

Traumatic and repeated injuries commonly cause synovitis. It usually accompanies an underlying joint injury that has chipped or roughened any of the surfaces in your knee. Joint diseases, especially rheumatoid arthritis and gout, can also cause synovitis.

Can a child get transient synovitis more than once?

Toxic synovitis usually goes away within a week or two, but sometimes can last for 4–5 weeks. While most kids have no long-term effects from it, some can develop toxic synovitis multiple times during childhood.