MSK: Transient Synovitis Flashcards
What is another term for transient synovitis?
Irritable hip
It is the most common cause of hip pain in children aged…
2 to 12
What can it be difficult to distinguish from?
The much more serious (early stage) septic arthritis
Is it more common in male or females?
Male 2:1
What causes it?
Inflammation of the synovial lining of the hip, often follows or accompanied by a viral infection
How does it present?
Sudden onset of pain in hip or a limp Child reluctant to weight bear Often still able to walk with difficulty (unlike septic arthritis where they often cannot walk at all) Mild/absent fever Child looks well
Is there pain at rest?
No
There is decreased range of movement on examination, particularly..
Internal rotation
Where can the pain often refer to?
The knee
In a small proportion of children, transient synovitis precedes what?
The development of Perthes disease
What will an x ray show?
Usually normal
May show some joint space widening
What x rays should be done?
AP
Lateral
Frog leg
What bloods should be done to rule out septic arthritis?
FBC
CRP
USS are not routinely performed, but they can show..
Fluid in joint
How is it managed?
Make sure you are confident it is not septic arthritis (no fever, weight bearing, inflammatory markers not raised)
Resolves less than 1 week usually
NSAIDS e.g ibuprofen 10mg/kg TDS
What differentials are there?
Septic arthritis
Perthes disease
Slipped capital femoral epiphysis
What is the incidence of transient arthritis vs septic arthritis?
10:1
