Transient Synovitis of the Hip

Key Points:

Description:

Self-limited inflammatory joint condition of unknown etiology.  The hip joint is most commonly affected.

Evaluation

A thorough history, examination, and published diagnostic criteria should be used in the evaluation and management of patients with acute onset of pain, limp, or inability to walk.  No single laboratory or imaging study will be definitive to confirm or exclude transient synovitis.  Septic arthritis is the primary concern due to the high complication rate with a delay in diagnosis and treatment.

Epidemiology:

Incidence/Prevalence:

Clinical Findings:

History 


Physical Examination 

Lab

Imaging Studies:

Plain radiographs 

Ultrasound 

MRI 

Treatment:

Outcomes

Complications:

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References:

  1. Caird, MS, et.al., Factors Distinguishing Septic Arthritis from Transient Synovitis of the Hip in Children. A Prospective StudyJ Bone Joint Surg Am, 2006 Jun; 88 (6): 1251 -1257
  2. Heyworth, BE, et.al., Management of Pediatric Patients with Synovial Fluid White Blood-Cell Counts of 25,000 to 75,000 Cells/mm3 After Aspiration of the Hip.  J Bone Joint Surg Am, 2015 Mar 04; 97 (5): 389 -395.
  3. Kocher,MS, et.al., Validation of a Clinical Prediction Rule for the Differentiation Between Septic Arthritis and Transient Synovitis of the Hip in ChildrenJ Bone Joint Surg Am, 2004 Aug; 86 (8): 1629 -1635
  4. Luhmann, SJ, Jones,A, et.al., Differentiation Between Septic Arthritis and Transient Synovitis of the Hip in Children with Clinical Prediction AlgorithmsJ Bone Joint Surg Am, 2004 May; 86 (5): 956 -962.
  5. Nouri A et. al., Transient Synovitis of the hip: a comprehensive review. J Pediatr Orthop B. 2014 Jan;23(1):32-36
  6. Sultan J, Hughes PJ. Septic arthritis or transient synovitis of the hip: the value of clinical prediction algorithyms. J Bone Joint Surg (Br) 2010; 92B(9): 1289-1293

Top Contributors:

Matthew Boyle MD