Transient Synovitis

Transient Synovitis:

Transient synovitis is a hip joint inflammation that produces discomfort, a limp, and the inability to bear weight. This appears as the most prevalent cause of hip discomfort in prepubescent children. It happens when a viral infection, such as an upper respiratory illness, spreads to the hip joint and settles there. Toxic synovitis is another name for it. That’s a terrifying name, but it’s not because your child was exposed to a toxin from outside his or her body. Instead, other healthcare experts believe the body responds to toxins produced by a virus that has been fought off elsewhere in the body.

The term “transient” refers to something that only exists for a short period of time. This ailment usually goes away in 7 to 10 days. If you see signs and symptoms of transient synovitis in your kid, you should quickly take your child to see a doctor about this dangerous illness.

What causes Transitory Synovitis?

Transient synovitis has no recognized etiology. The synovial membrane that surrounds the hip becomes inflamed for unknown reasons, according to experts.

Children are at Risk for Transient Synovitis

The most prevalent age group for transient synovitis refers to children aged 2 to 8. Boys appear two to four times more likely than girls to get the illness. It usually happens after a viral illness, such as an upper respiratory virus, in youngsters.

Clinical Manifestations

Although transitory synovitis can affect people of any age, it becomes more common in children aged 3 to 8, with an average age of onset of 6 years. In the 7-14 days before symptom onset, approximately 70% of all afflicted children had a generic upper respiratory tract infection. Symptoms generally appear suddenly and include discomfort in the groin, anterior thigh, or knee that may originate in the hip. These youngsters can normally bear weight on the damaged leg and walk with an antalgic gait with the foot turned externally. Unless there is a substantial effusion, the hip is not kept flexed, abducted, or laterally rotated. A low-grade fever of 100.4°F is common.

Symptoms of Transient Synovitis

Inflammation and discomfort around the hip joint are sometimes caused by transient synovitis. The symptoms normally appear within one to three days and disappear within a few days. In children with transitory synovitis of the hip, the following symptoms occur:

• Hip pain that makes it difficult to move
• Knee and hip discomfort
• Walking difficulties or a limp
• Fever with the hip flexed and rotated

The fact that these symptoms are quite similar to those of septic, or infected hip joint becomes troubling. Bacterial infections in the hip joint are dangerous and may necessitate surgery. As a result, any youngster experiencing hip discomfort or limping should quickly get evaluated by a healthcare specialist to discover the source of their symptoms.

Complications:

There have been rumors regarding probable problems after transitory synovitis in the past. However, the current opinion reveals no evidence of a higher risk of problems following transitory synovitis. Coxa Magna refers to an overgrowth of the femoral head and width of the femoral neck, as well as alterations in the acetabulum, which can result in femoral subluxation.

Diagnosing Transient Synovitis of the Hip

To determine whether or not a bacterial infection exists in the hip joint, blood tests can verify infection. Unfortunately, the outcomes of these tests in both synovitis and infection might seem the same.

So to verify the hip infection, a doctor inserts a needle into the hip joint to check the fluid within the joint. The hip joint of patients who have a bacterial infection will have pus in it. Surgery can remove the infection in these children. A period of observation in the hospital or emergency department for many children who are suspected of having transient synovitis is adequate to make the diagnosis. A bacterial infection in children tends to progress quickly, whereas synovitis in children improves gradually. As a result, simply keeping a careful eye on a child for a period of time becomes enough to diagnose synovitis.

Differential Diagnoses

Bone fractures, including a toddler’s fracture (spiral shinbone fracture), can also cause discomfort and limping, but they are uncommon in the hip joint. When bruises occur, soft tissue damage may exist. The following illnesses can cause an irritable hip:

• Perthes disease occurs when the blood supply to the hip no longer exists — causing injury to the head of the femur or the thigh bone.
• Fracture or contusion of the hip: Both of these traumas can cause the hip to flare up.
• A tumor in the hip might induce symptoms that appear similar to the irritable hip syndrome.
• When juvenile idiopathic arthritis (JIA) affects children under the age of 16, it has the potential to produce problems with the hip joint.

Septic arthritis and osteomyelitis are two further possibilities. Each of these factors can lead to high C-reactive protein levels and sedimentation rates in a critically ill kid. Sedimentation is the separation of red blood cells from blood serum, which is a feature of the inflammatory response. Inflammation causes the body to release C-reactive protein, which is why irritable hip symptoms cause higher levels.

What Tests Can Determine Transient Synovitis?

Transient synovitis is a diagnosis by exclusion, which means it’s only diagnosed after other, potentially more hazardous causes of acute hip pain have been ruled out. Because there are no clear diagnostic criteria for suspected transitory synovitis, the number of tests will be determined by the necessity to rule out other, more serious disorders. It is critical to rule out the possibility of septic arthritis. This is because if septic arthritis in children is ignored, it can lead to serious problems. The physician’s clinical competence is used to rule out septic arthritis, which is reinforced by basic laboratory tests and pertinent imaging modalities. Additionally, doctors need caution about ruling out acute osteomyelitis, which frequently coexists with septic arthritis of the hip in youngsters. To rule out other, more serious causes of hip pain, the following tests take place.

• Physical exam.
• X-rays.
• Blood work (CBC, CRP, and ESR).
• A hip ultrasound checks for fluid accumulation.

Transient Synovitis of the Hip Treatment

Rest will help your child’s hip heal. To minimize swelling and inflammation around the hip joint, your kid may need to take a Nonsteroidal anti-inflammatory drug such as ibuprofen (brand names: Advil, Motrin). Your doctor may also recommend that you administer heat to your child’s hip. Massage may also help the region to feel better. Your child’s doctor will most likely want you to take his or her temperature on a regular basis and report any temperature above 99.5°F. A fever might indicate that your child may suffer from another illness.

Your doctor may want to see your child 12 to 24 hours after the first visit to ensure that he or she continues to get better. The child’s hip will most likely improve in 3 or 4 days with rest and medication. Your youngster can continue normal activities after the pain subsides. Transient synovitis of the hip causes no consequences in most youngsters. They have fully recovered. In around 6 months, your doctor may want to take another X-ray of your child’s hip to make sure everything looks ok.

What to Anticipate from these Examinations?

Tests are performed to see if the hip appears irritated, inflamed, or infected. All of our X-rays are taken during your clinic visit. Ultrasound tests occur in radiology and the doctor can order the test prior to your appointment. Your child’s blood test can be taken at several places in the DFW area.  If these tests need to be conducted, your doctor may need a day or two to finish everything before making a diagnosis.

See Doctors that Specialize in Children

Orthopedics is a specialty of our doctors and surgeons at Medical City Children’s Orthopedics and Spine Specialists. They understand your concerns, can answer your questions regarding your condition, and know how to use their specialized knowledge to assist you.  Richard Hostin, MD,  Shyam Kishan, MD, and Kathryn Wiesman, MD, have many years of training and experience in Spine and Back Pain for kids, and adolescents, and can help them get back to living the life they love.

Finally, our board-certified physicians and fellowship-trained orthopedic surgeons use the full range of treatments to treat their spine patients. Medical City Children’s Orthopedics and Spine Specialists are experts with offices in Dallas, Arlington, Frisco, and McKinney, TX, and offer cutting-edge technology, comprehensive care, and dedicated facilities to ensure the best possible care for their patients. Call today to make an appointment for your child.

Questions to Ask Your Doctor at Our Office

• What causes hip discomfort in my child?
• What treatment appears as the most effective?
• Do I need to regularly take my child’s temperature? If he/she gets a fever, what should I do?
• How long will it take until my child’s pain goes away?
• What can I do at home to assist my child cope with his or her pain?
• Will my child’s symptoms reappear?
• Can my child safely engage in physical activity? Okay, what type of workouts are you talking about?

____________________

National Institute of Health: Transient Synovitis