Transient Synovitis
synonyms: transient synovitis, TS, toxic synovitis
Transient Synovitis ICD-9
Transient Synovitis Etiology / Epidemiology / Natural History
- Most common cause of acute hip pain in children aged 3-10 years
- Nonspecific inflammation and hypertrophy of the synovial membrane identified in biopsy speicimens.
Transient Synovitis Anatomy
Transient Synovitis Clinical Evaluation
- Unilateral hip or groin pain. May report medial thigh or knee pain.
- Recent history of an upper respiratory tract infection, pharyngitis, bronchitis, or otitis media in 50% of patients
- Limp may be only initial complaint
- Generally afebrile or mildly elevated temperature; high fever is rare.
- Hip pain with passive ROM.
Transient Synovitis Xray / Diagnositc Tests
- A/P pelvis, A/P and frog lateral of the hip. May be normal or demonstrated soft tissue swelling / effusion / joint space widening.
- Ultrasonography guided aspiration: Indicated for temp >99.5°F, or ESR >20, of severe hip pain with ROM. Demonstrates an effusion that causes bulging of the anterior joint capsule.
- CBC and ESR may be slightly elevated. ESR >20 mm/h and/or temperature>37.5°C indicates septic hip.
Transient Synovitis Classification / Treatment
- NSAIDs, activity limitations, NWB while painful, consider bedrest.
- Hosptial admission indicated for observation in equivocal cases.
- Patients generally improve markdly in 24-28 hours. May have mild symptoms for several weeks.
Transient Synovitis Associated Injuries / Differential Diagnosis
Transient Synovitis Complications
Transient Synovitis Follow-up Care
- Repear xrays in 6-12 months to eval for Perthes disease.
Transient Synovitis Review References
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