Transient synovitis of the hip

padlock-lockedLog in or subscribe to access all of BMJ Best Practice
Last reviewed: 8 Nov 2022
Last updated: 06 Dec 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • limited movement
  • pain
  • limp
  • positive log roll
More key diagnostic factors

Other diagnostic factors

  • abducted and externally rotated hip
  • fever
Other diagnostic factors

Risk factors

  • 2 to 12 years of age
  • male sex
  • history of recent viral illness
More risk factors
padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Diagnostic investigations

1st investigations to order

  • FBC
  • erythrocyte sedimentation rate
  • CRP
  • x-ray
More 1st investigations to order

Investigations to consider

  • ultrasound
  • MRI with contrast
More investigations to consider
padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Treatment algorithm

ACUTE

all patients

padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Contributors

Authors

Ishaan Swarup, MD, FAAOS, FAAP

Assistant Professor of Clinical Orthopaedic Surgery

Director, Pediatric Orthopaedic Trauma

Associate Fellowship Director, Pediatric Orthopaedic Surgery

University of California

San Francisco

CA

Disclosures

IS is the author of a reference cited in this topic.

Acknowledgements

Dr Ishaan Swarup would like to gratefully acknowledge Professor James McCarthy and Dr Jaime Denning, previous contributors to this topic.

Disclosures

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.

Peer reviewers

Norm Otsuka, MD

Assistant Chief of Staff

Shriners Hospital for Children

Los Angeles

CA

Disclosures

NO declares that he has no competing interests.

Michael Smith, MB, BChir, FRCS

Consultant Orthopaedic Surgeon

Department of Orthopaedics

Guy's & St Thomas' Hospital

London

UK

Disclosures

MS declares that he has no competing interests.

Peter Cundy, MBBS, FRACS

Head of Orthopaedic Surgery

Women's & Children's Hospital

Adelaide

Australia

Disclosures

PC declares that he has no competing interests.

Use of this content is subject to our disclaimer