Transitory synovitis of the hip

From greek.doctor
  • 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