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Detailed information of TRANSIENT SYNOVITIS
TRANSIENT SYNOVITIS
DEFINITION:
A disorder of the hip of unknown etiology characterized by hip
pain and limp.
EPIDEMIOLOGY:
- incidence: ?
- most common cause of hip pain in children
- age of onset:
- risk factors:
PATHOGENESIS:
- unknown but often preceded by an upper respiratory tract
infection
CLINICAL FEATURES:
- bilateral in about 4% of cases
- recurrence is frequent & accompanied by low-grade fever
- child is rarely ill or febrile
2. Limp
- insidious onset of painful limp 1-2 weeks after a viral
upper respiratory tract infection
- can stand with support and test range of motion:
- loss of internal rotation and abduction
- may hold hip in flexed position
3. Pain
- vague pain in hip, thigh, or knee
- sudden or gradual onset lasting on average about 6 days
INVESTIGATIONS:
- AP and frogleg lateral views of the hips:
- occasional capsular distension or slight widening of the
joint space with lateral displacement of femoral head
2. Bone Scan
- normal or may show transient decrease in uptake
2. Blood
- normal except increase ZSR (in 50% of cases)
3. Hip Aspirate
- normal (sterile) or minimal increase in cell count
MANAGEMENT:
- bedrest +/- hip in 45 degrees flexion
- analgesic or NSAID's
- aspiration may be therapeutic - increase range of motion and
decrease pain
2. Prognosis
3. Complications
- Legg-Calve-Perthes Disease (1.5%) secondary to increased
intracapsular pressure and subsequent vascular occlusion
- coxa magna
- osteoarthritis
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Pediatric Database - TRANSIENT SYNOVITIS
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