Summary about Disease
Transient synovitis, also known as toxic synovitis, is a common, temporary condition that causes hip pain and limping in children, most often between the ages of 3 and 8. It involves inflammation of the synovium, the lining of the hip joint. The condition is usually self-limiting and resolves within a week or two. While it can be alarming for parents, it typically does not cause long-term damage.
Symptoms
Hip pain (most common)
Limping or refusal to walk
Pain may be felt in the groin, thigh, or knee
Holding the leg in a flexed, externally rotated position
Low-grade fever (less common)
Irritability
Causes
The exact cause of transient synovitis is unknown, but several theories exist:
Viral infection: It often occurs after a recent viral upper respiratory infection.
Trauma: Minor injury to the hip may play a role.
Allergic reaction: This is another proposed mechanism.
Inflammation: The body's immune response to one of these factors triggers inflammation in the hip joint.
Medicine Used
Pain relievers: Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) are typically used to manage pain and reduce inflammation.
In rare cases, NSAIDs: Sometimes a doctor might prescribe stronger NSAIDs.
Is Communicable
Transient synovitis is not communicable. It is not contagious and cannot be spread from one person to another.
Precautions
Rest: Encourage the child to rest and avoid activities that aggravate the pain.
Follow doctor's instructions: Administer medications as prescribed.
Monitor symptoms: Watch for any worsening of symptoms, such as high fever, severe pain, or inability to move the leg.
Follow-up: Attend all scheduled follow-up appointments with the doctor.
How long does an outbreak last?
Transient synovitis typically lasts for 3 to 10 days, with most cases resolving within a week or two. Symptoms usually improve significantly within a few days of rest and pain relief medication. In some cases, it can persist for up to several weeks.
How is it diagnosed?
Physical examination: The doctor will examine the child's hip, range of motion, and gait.
Medical history: The doctor will ask about recent illnesses, injuries, and symptoms.
Blood tests: Blood tests, such as a complete blood count (CBC) and inflammatory markers (ESR, CRP), may be performed to rule out infection or other inflammatory conditions.
X-rays: X-rays are often taken to rule out other conditions, such as fractures or bone infections.
Ultrasound: An ultrasound may be used to detect fluid in the hip joint. In some cases, the doctor may order MRI if they suspect another condition.
Timeline of Symptoms
Initial phase: Sudden onset of hip pain and limping, often after a viral illness.
Acute phase: Pain is most intense, and the child may refuse to walk. The leg is often held in a flexed, externally rotated position.
Recovery phase: Pain gradually decreases, and the child's ability to walk improves. Limping becomes less pronounced.
Resolution: Pain and limping completely resolve, and the child returns to normal activity levels.
Important Considerations
Rule out other conditions: It's crucial to rule out other, more serious conditions that can cause hip pain in children, such as septic arthritis, Legg-Calvé-Perthes disease, and juvenile idiopathic arthritis.
Follow-up is important: Even if the symptoms improve quickly, follow-up with the doctor is important to ensure complete resolution and to monitor for any recurrence.
Recurrence: Transient synovitis can recur in some children.
Serious Complications: While rare, be vigilant for signs of worsening conditions or serious complications.