Transient synovitis of the hip is a self-limiting inflammatory disorder of the hip that commonly affects young children between 2 and 12 years of age.
The most important differential diagnosis to exclude is septic arthritis of the hip.
More common in boys.
Presents acutely with mild to moderate hip pain and limp.
Treatment is supportive with activity restrictions and non-steroidal anti-inflammatory drugs as needed.
Transient synovitis is a self-limiting inflammatory disorder of the hip that commonly affects young children.
History and exam
Key diagnostic factors
- presence of risk factors
- limited movement
- positive log roll
Other diagnostic factors
- abducted and externally rotated hip
- 2 to 12 years of age
- male sex
- history of recent viral illness
1st investigations to order
- erythrocyte sedimentation rate
Investigations to consider
- MRI with contrast
Ishaan Swarup, MD, FAAOS, FAAP
Assistant Professor of Clinical Orthopaedic Surgery
Director, Pediatric Orthopaedic Trauma
Associate Fellowship Director, Pediatric Orthopaedic Surgery
University of California
IS is the author of a reference cited in this topic.
Dr Ishaan Swarup would like to gratefully acknowledge Professor James McCarthy and Dr Jaime Denning, previous contributors to this topic.
JM is a board member for the Pediatric Orthopaedic Society of North America. He has given workshops at annual teaching meetings for DePuy Synthes, received royalties from Lippincott Williams & Wilkins for editing a book, and received grant and travel money from Nuvasive. JM has worked as a consultant for Nuvasive within the past 5 years, and frequently gives academic ground rounds lectures. JD declares that she has no competing interests.
Norm Otsuka, MD
Assistant Chief of Staff
Shriners Hospital for Children
NO declares that he has no competing interests.
Michael Smith, MB, BChir, FRCS
Consultant Orthopaedic Surgeon
Department of Orthopaedics
Guy's & St Thomas' Hospital
MS declares that he has no competing interests.
Peter Cundy, MBBS, FRACS
Head of Orthopaedic Surgery
Women's & Children's Hospital
PC declares that he has no competing interests.
- Septic arthritis
- Lyme arthritis
- ACR appropriateness criteria: acutely limping child up to age 5
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