Transient Synovitis of the Hip

Key Points:


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


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.



Clinical Findings:


Physical Examination 


Imaging Studies:

Plain radiographs 






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  2. Heyworth, BE,, 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,, 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
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  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

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Matthew Boyle MD