Transient Synovitis

Self‐limiting inflammation of the synovium of a joint, most commonly the hip

Aetiology

  • Commonly occurs shortly after an upper respiratory tract infection (usually viral) although sometimes no cause is found
  • Typical age is between 2 and 10
    • Commonest cause of hip pain in childhood
  • Boys are more commonly affected than girls

Clinical presentation

  • Limp/reluctance to weight bear on the affected side
  • Range of motion may be restricted
  • May be low grade fever but child is not systemically unwell

Investigations

  • X-ray - to exclude Perthes disease
  • CRP - if normal/near normal can exclude septic arthritis
  • If uncertainty between transient synovitis and septic arthritis - aspiration of the hip or open surgical drainage
  • MRI - rule out osteomyelitis of the proximal femur

Management

  • NSAIDs and rest
  • Pain generally resolves within a few weeks but if there is no resolution then another cause for hip pain should be sought