An Overview of Transient Synovitis of the Hip in Children

Transient synovitis of the hip joint is a condition that occurs in young children. The cause of transient synovitis is not well understood, but it is likely related to a viral illness of the child. Transient synovitis tends to occur in children younger than 11 years old.

It is sometimes called toxic synovitis. That is a scary name, but it isn’t due to being exposed to a toxic substance from outside the body. Instead, it may be called that because some healthcare providers think it is a reaction by the body to toxins released by a virus that has been fought off elsewhere in the body, such as after a cold.

Symptoms of Transient Synovitis

Transient synovitis causes inflammation and pain around the hip joint. The symptoms tend to begin quickly over 1 to 3 days and usually resolve over the next several days. The following symptoms are common in children with transient synovitis of the hip:

• Pain with movement of the hip
• Hip and knee pain
• Difficulty walking or a limp
• Holding the hip flexed and rotated
• Fever

The concerning aspect is that these symptoms are very similar to a septic, or infected, hip joint. Bacterial infections of the hip joint are more serious and may require surgery for treatment. Therefore, any child with hip pain or a limp must be carefully assessed by a healthcare provider to determine the cause of their symptoms.

Diagnosis of Transient Synovitis of the Hip

The most important part of the diagnosis is to ensure there is not a bacterial infection within the hip joint. Blood work can be done to assess for signs of infection and inflammation. Unfortunately, the results of these studies can be similar in both synovitis and infection.

In some patients, a needle will be inserted into the hip joint to assess the fluid within the joint. Patients with a bacterial infection in the hip joint will have pus in the joint. These children will have surgery to clean out the infection.

In many children who are suspected to have transient synovitis, a period of observation in the hospital or emergency room is sufficient to make the diagnosis. Children who have a bacterial infection tend to rapidly worsen, while children with synovitis steadily improve. Therefore, just watching the child closely for a period of time is often sufficient to make the diagnosis of synovitis.

Treatment of Hip Synovitis

If the diagnosis is transient synovitis, the most important aspect of treatment is time. Some mild anti-inflammatory medication can help to alleviate pain, and rest for a few days will help as well.

The child should be watched by a parent or responsible caregiver to ensure their condition does not worsen. In addition, regular temperature checks are important. Fevers should be reported to your healthcare provider.

Children who have transient synovitis of the hip usually recover completely. Children with transient synovitis of the hip should follow up with their healthcare provider to ensure all of the symptoms have resolved.