Transitory synovitis of the hip

• Transitory coxitis = transitory synovitis of the hip = irritable hip
  • Epidemiology
    • Most common cause of acute hip pain in children 3 – 8 years
    • Boys > girls
  • Etiology
    • Occurs without precipitating cause in most cases
    • May follow upper respiratory tract infections or trauma
  • Pathology
    • Synovitis of the hip
  • Clinical features
    • Almost always unilateral
    • After upper respiratory tract infections
      • This may give transitory coxitis a season appearance
    • Often recurs
    • Antalgic limp
    • Thigh/knee pain
    • Flexion contracture
    • Limited internal rotation
    • No fever
  • Diagnosis
    • ESR, CRP, WBC slightly raised
    • US/MRI show hip joint effusion
    • X-ray shows nothing
  • Treatment
    • The condition is self-limiting after a few weeks in most cases
    • Rest
    • NSAIDs
    • Joint fluid aspiration
      • This can also exclude septic arthritis, which may cause similar symptoms
  • Complications
    • The pressure caused by the effusion can cause avascular necrosis of the femoral head