Transient Synovitis of the Hip

Question 1

pathology

Answer 1

Self-limiting inflammation of the synovium jointMost commonly of the hip Shortly after an upper respiratory tract infection (usually viral)

Question 2

who gets it?

Answer 2

2-10 years boys> girls

Question 3

what is it?

Answer 3

Transient hip synovitis is the commonest cause of hip pain in childhood Other differentials: Septic arthritisPerthes diseaseJuvenile Idiopathic ArthritisRheumatoid Arthritis

Question 4

how does it present?

Answer 4

LimpReluctance to weight bear on affected sideROM may be restricted Not as much pain or loss of motion as septic arthritis Low grade feverNot systemically unwell or septic

Question 5

how is it investigated?

Answer 5

Radiographs – exclude PerthesCRP normal/near normal & clinical picture suggestive of TSOFTH – exclude septic arthritisIf doubt: aspiration of the hip (anaesthetic/ open surgical drainage to limit cartilage damage)MRI – may be helpful in equivocal cases – osteomyelitis of proximal femur is possible

Question 6

how is it managed?

Answer 6

NSAID and rest Resolves within a few weeks – if not: other causes sought (JIA, early Perthes)