Transient synovitis {toxic synovitis} of the hip is characterized by all of the following, except -
TRANSIENT SYNOVITIS : Definition: A self-limiting condition in which there is inflammation and swelling of the tissue around the hip joint. * Most common cause of acute hip pain in children 3-8 years old. * Boys affected twice > girls * The exact cause is unknown. Clinical Features Pain --groin region, front of thigh, sometimes up to knee Limping, crying Symptoms occur-- intermittently or after activity History of sore throat, cough, ear infection prior to limp pain O/E: * Slight wasting may appear * Restriction of all movements mostly at the extremes of the movement * Tenderness at the joint * Diagnosis of exclusion once trauma and infection are excluded. * Diagnosis is made primarily based on clinical features - Lab investigations are normal - X-ray show nothing more than slight widening of medial joint space . Management * Symptomatic * Bed Rest * Decrease activity of the joint * Traction -- might increase intra-aicular pressure * Joint Aspiration -- symptoms relieve but is sho-lived Mostly symptoms resolves within few days Weight bearing only after effusion disappears Good prognosis but repeated episodes may occur REF : MAHESWARI 9TH ED
May follow upper respiratory infection
ESR and white blood cell counts are usually normal
Ultrasound of the joint reveals widening of the joint space
The hip is typically held in adduction and internal rotation
Pediatric orthopedics