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Transient synovitis of the hip

Last reviewed: 5 Sep 2023
Last updated: 06 Dec 2022



History and exam

Key diagnostic 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

Diagnostic investigations

1st investigations to order

  • CBC
  • erythrocyte sedimentation rate
  • CRP
  • radiograph
More 1st investigations to order

Investigations to consider

  • ultrasound
  • MRI with contrast
More investigations to consider

Treatment algorithm


all patients



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



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.

Peer reviewers

Norm Otsuka, MD

Assistant Chief of Staff

Shriners Hospital for Children

Los Angeles



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.

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