Materiały źródłowe

• #1 Transient synovitis (irritable hip)

  https://www.rch.org.au/kidsinfo/fact_sheets/Transient_synovitis/

  Transient synovitis (irritable hip) is the most common cause of limping in children. It is due to inflammation (swelling) of the lining of the hip joint. […] In most cases of irritable hip, your child will have recently recovered from a viral infection. Sometimes, the condition occurs after a fall or injury. […] Irritable hip is most often seen in children aged between three and 10 years old. It is not serious, and will get better on its own with rest. […] Transient synovitis (irritable hip) is the most common cause of limping in children. […] It is generally a mild condition that will get better on its own with rest, usually within two weeks. […] Non-steroidal anti-inflammatory drugs, e.g. ibuprofen, may help relieve the pain and reduce inflammation.

• #2 Hip pain in children (irritable hip)

  https://www.nhs.uk/conditions/hip-pain-children-irritable-hip/

  Hip pain in children is most often caused by a condition called irritable hip, which usually gets better on its own. […] A condition called irritable hip is the most common cause of hip pain in children. This is where the hip joint becomes sore and inflamed. […] Irritable hip can be painful, but it’s not usually serious and often gets better by itself.

• #3 Toxic Synovitis (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/toxic-synovitis.html

  Toxic synovitis (also known as transient synovitis) is a common cause of hip pain and limping in children. […] Doctors don’t know its exact cause, but some kids develop it after having a viral infection (such as a cold or diarrhea). […] Toxic synovitis can happen at any age, but is most common in kids between 3 and 8 years old. […] Sometimes toxic synovitis can be confused with septic arthritis, or infectious arthritis, a more serious condition caused by a bacterial infection that invades the joints and can cause long-term joint damage. […] When kids have toxic synovitis, the pain starts suddenly and usually is only on one side of the body. […] In babies, the most common signs of toxic synovitis are abnormal crawling and crying, and they may cry when their hip joints are being moved, such as during diaper changes. […] Treatment for toxic synovitis usually includes anti-inflammatory drugs such as ibuprofen or naproxyn. […] While most kids have no long-term effects from it, some can develop toxic synovitis multiple times during childhood.

• #4 Irritable hip (transient synovitis): Symptoms, causes, and diagnosis

  https://www.medicalnewstoday.com/articles/166614

  Irritable hip results from hip joint inflammation. It is a common cause of hip pain and limping in children aged 10 years or younger. […] Doctors refer to irritable hip as acute transient synovitis or toxic synovitis. It is most common between the ages of 3 and 10 years and occurs more frequently in boys than girls. […] In acute transient synovitis, inflammation occurs in the synovial membrane that surrounds the hip. The underlying reason for this is not clear. […] Possible explanations include: A viral infection. The inflammation in the hip may be an allergic reaction that occurs when the immune system responds to infection elsewhere in the body. […] A fall or another injury. A child may experience physical trauma before the symptoms of irritable hip become clear.

• #5 Transient Synovitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459181/

  Transient synovitis is an acute, nonspecific, inflammatory process affecting the joint synovium, particularly in the pediatric patient population, where it frequently manifests as hip pain. […] The exact etiology of transient synovitis is unknown. The literature demonstrates multiple proposed etiologic theories, but none of these postulated hypotheses have been conclusively substantiated. Proposed risk factors include but are not limited to: Preceding upper respiratory infection, Preceding bacterial infection, Preceding trauma. […] Many pediatric patients will present with a history of preceding upper respiratory infection symptoms, or in the setting of recent trauma. […] According to Kastrissianakis and Beattie, patients diagnosed with transient synovitis are more likely to have experienced preceding viral symptoms, including vomiting, diarrhea, or common cold symptoms.

• #6 Transient Synovitis In Kids | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/transient-synovitis/

  Transient synovitis is an inflammation in the hip joint that causes pain, limp and sometimes refusal to bear weight. This occurs in pre-pubescent children and is the most common cause of hip pain. […] The cause of transient synovitis is unknown. Experts are unclear as to why the synovial membrane that surrounds the hip becomes inflamed. […] Transient synovitis is most common in children 2-8 years of age. Boys are affected two to four times as often as girls. It most commonly occurs in children following a viral infection such as an upper respiratory virus. […] A diagnosis for transient synovitis is a diagnosis of exclusion. By working with radiology, infectious disease and rheumatology, our experts can rule out all other causes of hip pain. Ruling out other causes can lead to a proper diagnosis.

• #7 Transient Synovitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459181/

  Other hypothesized risk factors include postvaccine or drug-mediated hypersensitivity reactions or certain allergic predispositions. […] Although transient synovitis remains a diagnosis of exclusion, provocative maneuvers such as the basic log roll or performing the Patrick test can provide valuable information if the patient can tolerate them. […] Transient synovitis remains a diagnosis of exclusion, although these studies have highlighted the diagnostic utility of a synovial fluid aspiration and analysis. […] The major complication associated with transient synovitis is a recurrence of symptoms.

• #8 Transient Synovitis | A hip joint inflammation | We Diagnose & Treat

  https://medicalcitykidsortho.com/transient-synovitis/

  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. […] 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.

• #9 Transient Synovitis of the Hip | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/transient-synovitis/

  Transient synovitis of the hip (also called irritable hip or toxic synovitis) is a common cause of sudden-onset hip pain and limping in young children. […] The exact cause is unknown. Many children develop transient synovitis following an infection with a virus (such as a cold), so one theory is that the condition is caused by a virus. […] Irritable hip is a condition which gets better without treatment, usually within five to seven days; however symptoms last several weeks in some children.

• #10 Transient Synovitis (Irritable Hip) – almostadoctor

  https://almostadoctor.co.uk/encyclopedia/transient-synovitis-irritable-hip

  Transient synovitis (a.k.a. Irritable Hip) is the most common cause of hip pain in children aged 3-8. […] It is caused by inflammation of the synovium of the hip. […] Other causes of hip pain in children include viral arthritis (common), juvenile arthritis (rare). […] The condition is self limiting and usually resolves within a few days. […] Most common cause of hip pain in children aged 3-8. […] Non specific inflammation of the synovial lining of the hip often 1-2 weeks after an upper respiratory tract infection (URTI).

• #11 Transient synovitis: What parents should know – CHOC – Children’s health hub

  https://health.choc.org/transient-synovitis-what-parents-should-know/

  Transient synovitis – also known as toxic synovitis – is the temporary inflammation of the hip that can cause limping and pain in the hip and leg. […] Doctors don’t know the exact cause of transient synovitis, but some children can develop it after having a viral infection, such as a cold or diarrhea. This is why some doctors think transient synovitis is caused by substances made by the body’s immune system to fight infection. […] Sometimes transient synovitis can be confused with septic arthritis, or infectious arthritis. This is a more serious condition caused by a bacterial infection that invades the joints and can cause long-term joint damage. […] When kids have transient synovitis, the pain starts suddenly and usually is only on one side of the body. […] The most common signs of transient synovitis in babies are abnormal crawling and crying. […] Treatment for transient synovitis usually includes anti-inflammatory drugs such as ibuprofen or naproxen. Your child may take these for up to 4 weeks until the inflammation goes away.

• #12 What Is Transient Synovitis of the Hip in Children?

  https://www.icliniq.com/articles/parenting-and-childrens-health/pediatric-transient-synovitis-of-hip

  Transient synovitis of the hip is a temporary inflammatory condition of the synovium that occurs in children who have had recent viral infections or trauma. […] Transient synovitis of the hip is also known as toxic synovitis or irritable hip. In this condition, there is inflammation of the lining of the joint (the synovium of the hip joint) in children. […] The exact causative factor for transient synovitis of the hip in children has not yet been identified. However, some factors are considered to be interlinked in the causation of this synovial inflammation in children like: A recent medical history of viral attack, especially an infection of the upper respiratory tract manifesting as a cold or cough. […] When the child has a viral infection, the body tries to protect the child by initiating an immune response. This immune response triggers inflammation and causes resultant inflammatory products to accumulate in the circulating blood.

• #13 Childhood Hip Pain | Norton Children’s Louisville, Ky.

  https://nortonchildrens.com/news/childhood-hip-pain/

  If your child suddenly develops hip pain or starts limping, and they were not injured, it could be a temporary condition called transient synovitis. […] Transient synovitis, also called toxic synovitis, is temporary inflammation of the hip that can cause limping and leg or hip pain in children. “This condition often develops after having a viral infection, such as a cold or stomach virus, and the pain could be an immune system response as the body fights the infection. […] “It usually goes away within a week and causes no long-term issues,” said Joshua W. Meier, M.D., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville. […] Childhood hip pain from transient synovitis often starts suddenly and is usually on one side of the body. […] Sometimes transient synovitis can be confused with septic arthritis, which is a more serious condition caused by a bacterial infection in the joints.

• #14 Transient Synovitis: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/1007186-overview

  Transient synovitis (TS) is the most common cause of acute hip pain in children aged 3-10 years. The disease causes arthralgia and arthritis secondary to a transient inflammation of the synovium of the hip. […] No definitive cause of transient synovitis is known, although the following have been suggested: Patients with transient synovitis often have histories of trauma, which may be a cause or predisposing factor. One study found an increase in viral antibody titers in 67 of 80 patients with transient synovitis. Postvaccine or drug-mediated reactions and an allergic disposition have been cited as possible causes. […] Little data are available regarding the frequency of this illness. However, excluding infections and trauma, transient synovitis is one of the most common causes of joint pain in the pediatric age group. In 80-85% of children who present with a limp in the absence of trauma, transient synovitis of the hip is the cause. […] Transient synovitis affects boys twice as often as girls. Transient synovitis most frequently occurs in children aged 4-10 years; however, transient synovitis has been reported in a 3-month-old infant and in adults.

• #15 Transient Synovitis vs. Septic Arthritis: Symptoms, Causes, More

  https://www.healthline.com/health/transient-synovitis-vs-septic-arthritis

  Transient synovitis, also called irritable hip or toxic synovitis, involves inflammation of the lining of the hip joint. It usually occurs in children. It often goes away within a couple of weeks. […] The cause of transient synovitis is not known. However, many children have a respiratory infection or recent trauma to their hip before it develops. It most frequently occurs in children 3-10 years old. […] Researchers continue to investigate potential viral causes, like parvovirus B19 and human herpesvirus 6. […] Transient synovitis commonly develops in children and causes sudden pain in one hip.

• #16 Irritable Hip Treatment Wallingford | Acute Transient Synovitis Southington, Meriden

  https://www.meganwolfmd.com/irritable-hip-orthopedic-sports-medicine-specialist-wallingford-meriden-southington-ct/

  Irritable hip, also known as acute transient synovitis, is a common disorder of childhood characterized by hip pain and limping. The exact cause of an irritable hip is unknown. But in some cases, the condition can occur because of viral infection (upper respiratory tract), a fall or injury. An irritable hip can also occur because of Perthes disease, a condition where the head of the thighbone deteriorates because of poor blood supply. […] A child with irritable hip will experience the following symptoms: Hip pain, Limping, Pain, which may spread to the groin, thigh and knee areas, Abnormal crawling, Abnormal crying, Slight fever.

• #17 Transient synovitis – Wikipedia

  https://en.wikipedia.org/wiki/Transient_synovitis

  Transient synovitis of hip (also called toxic synovitis; see below for more synonyms) is a self-limiting condition in which there is an inflammation of the inner lining (the synovium) of the capsule of the hip joint. The term irritable hip refers to the syndrome of acute hip pain, joint stiffness, limp or non-weightbearing, indicative of an underlying condition such as transient synovitis or orthopedic infections (like septic arthritis or osteomyelitis). […] Transient synovitis usually affects children between three and ten years old (but it has been reported in a 3-month-old infant and in some adults). It is the most common cause of sudden hip pain and limp in young children. […] The exact cause is unknown. A recent viral infection (most commonly an upper respiratory tract infection) or a trauma have been postulated as precipitating events, although these are reported only in 30% and 5% of cases, respectively.

• #18 Transient Synovitis Texas | OrthoTexas | Carrollton, TX

  https://www.orthotexas.com/transient-synovitis-causes-symptoms-and-treatment/

  Transient Synovitis, Toxic Synovitis or Irritable Hip is a medical condition observed in children between 3-8 years that causes pain in the hip joint followed by limping. […] The underlying cause is the inflammation in the lining of the synovial joint. […] The hip lining may be affected following a viral infection, usually of the upper respiratory system. […] A fall or an injury to the hip joint. […] Reaction or after effects of certain medicines or vaccines may cause inflammation.

• #19

  https://www.orthobullets.com/pediatrics/4030/transient-synovitis-of-hip

  Transient Synovitis of Hip is inflammation of the synovium and a common cause of hip pain in pediatric patients that must be differentiated from septic arthritis of the hip. […] most common cause of hip pain in the pediatric population. […] the exact cause of transient synovitis is largely unknown, however, may be related to viral infection (upper respiratory), bacterial infection (poststreptococcal toxic synovitis), trauma, higher interferon concentration, and allergic reaction. […] non-specific inflammation and hypertrophy of the synovial lining/membrane.

• #20 What Is Transient Synovitis of the Hip in Children?

  https://www.icliniq.com/articles/parenting-and-childrens-health/pediatric-transient-synovitis-of-hip

  In transient synovitis of the hip, there is an accumulation of the synovial fluid and effusion in the hip joint. This can put constant pressure on the child and cause constant hip pain in the affected children. […] The management strategy for transient synovitis of the hip in children is to provide supportive and adjuvant care as the condition is largely self-limiting. […] Hip pain and limping caused due to transient synovitis of the hip is always benign. It does not cause permanent damage or destruction of the hip joint.

• #21 Physiotherapy in Etobicoke, Toronto for Pediatric Pain – Transient Synovitis

  https://www.physiofirst.ca/Injuries-Conditions/Pediatric/Pediatric-Issues/Guide-for-Transient-Synovitis-of-the-Hip-in-Children/a~3061/article.html

  A blood test will show mild inflammation. If needed, the physician may order an ultrasound of the hip. This test will show any effusion (fluid collection) in the hip joint. Drawing the fluid out with a needle called needle aspiration will show if there is pus in the joint from septic (bacterial) arthritis. The fluid is clear in transient synovitis.

• #22 Hip Pain in Children (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/painful-hips-in-children

  It is a benign condition with a small amount of fluid in the joint. […] It can be managed with oral analgesics and observation. […] The child is usually systemically well and the ESR is either normal or slightly raised. […] Management includes rest and analgesia, with mobilisation once the pain has settled.

• #23 Transient synovitis – Wikipedia

  https://en.wikipedia.org/wiki/Transient_synovitis

  Transient synovitis is a diagnosis of exclusion. […] The diagnosis can be made in the typical setting of pain or limp in a young child who is not generally unwell and has no recent trauma. […] Blood tests may show mild inflammation. An ultrasound scan of the hip joint can show a fluid collection (effusion). […] The condition usually clears by itself within seven to ten days, but a small group of patients will continue to have symptoms for several weeks. […] Transient synovitis causes pain in the hip, thigh, groin or knee on the affected side. […] The pain and limp can range from mild to severe. […] Some children may have a slightly raised temperature; high fever and general malaise point to other, more serious conditions. […] The current consensus however is that there is no proof of an increased risk of complications after transient synovitis. […] The exclusion of septic arthritis is mainly built upon the physician’s clinical expertise and is supplemented by basic laboratory test and relevant imaging modalities. […] In transient synovitis, the joint fluid will be clear.

• #24 Transient Synovitis | A hip joint inflammation | We Diagnose & Treat

  https://medicalcitykidsortho.com/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. […] Transient synovitis has no recognized etiology. The synovial membrane that surrounds the hip becomes inflamed for unknown reasons, according to experts. […] 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. […] 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.

• #25 Hip Pain in Children (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/painful-hips-in-children

  The clinical challenge in paediatric hip pain is to distinguish urgent conditions such as infection of the hip joint from the more common irritable hip. […] Transient synovitis is one of the most common causes in children over 3 years of age but it has similar early symptoms to septic arthritis. […] The most common and significant causes of hip pain in children are: Transient synovitis (irritable hip) peaking at 3-8 years. […] Transient synovitis is the most common cause of hip pain in children between the ages of 3-10 years (peaking between 5 years and 6 years) and is more common in boys, often preceded by viral infection. […] Children with septic arthritis appear ill. […] The most common causative agent is Staphylococcus aureus. […] Transient synovitis typically has an acute onset, followed by spontaneous recovery with no systemic upset.

• #26 Review for the generalist: evaluation of pediatric hip pain | Pediatric Rheumatology | Full Text

  https://ped-rheum.biomedcentral.com/articles/10.1186/1546-0096-7-10

  Hip pathology may cause groin pain, referred thigh or knee pain, refusal to bear weight or altered gait in the absence of pain. […] A young child with an irritable hip poses a diagnostic challenge. […] Transient synovitis, one of the most common causes of hip pain in children, must be differentiated from septic arthritis. […] Hip pain may also be referred from low back or pelvic pathology. […] Transient synovitis and septic arthritis have similar early symptoms with the spontaneous onset of progressive hip, groin, or thigh pain; limp or inability to bear weight; fever; and irritability. […] Transient synovitis typically has an acute onset, and spontaneous recovery with no radiological abnormality or systemic upset. […] It occurs between the ages of 2 and 10 years (peaking between 5 and 6 years) and is more common in boys, often preceded by viral infection.

• #27 “Irritable Hip”: Diagnosis in the Emergency Department. A Descriptive Study Over One Year

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6314824/

  A limping child commonly presents to the emergency department (ED), often without a history of trauma. It is important that serious underlying pathology is ruled out before a diagnosis of benign irritable hip (IH). The aetiology of IH is not well understood and there may be geographical and seasonal variation. […] The most common cause of IH is transient synovitis (TS), pathologically defined by synovial inflammation and associated effusion, and diagnosed by ultrasound. However, children can present with features of IH but negative ultrasound. […] A post-infective state is the leading hypothesis, as an association has been shown between TS and preceding viral infections. However, no particular infective agent has been identified. […] The annual incidence of irritable hip in the GGC area was 177.7 per 100,000 children aged 0-14 years. The incidence of irritable hip was greater in boys, with a 1.9:1 boy:girl ratio. […] In our population, there was a preponderance of irritable hips presenting in March and April.

• #28 Physical or Occupational Therapy in Cleveland for Pediatric Pain – Transient Synovitis

  https://www.therapy-specialists.com/Injuries-Conditions/Pediatric/Pediatric-Issues/Guide-for-Transient-Synovitis-of-the-Hip-in-Children/a~3061/article.html

  Transient synovitis of the hip is also known as toxic synovitis or irritable hip. This condition affects young children (boys more than girls) most often. In fact, it’s the most common cause of acute hip pain in young children between the ages of three and 10. […] The exact cause of this problem is unknown. In some cases, it may develop after a recent viral infection (such as a cold or upper respiratory infection). In a smaller number of children, trauma to the hip is followed by transient synovitis. […] There is much debate about a possible link between transient synovitis and another condition called Legg-Calve-Perthes disease. […] Inflammation and effusion (swelling) can cause sudden hip pain. Usually only one hip is involved. […] The painful symptoms may travel to the thigh, groin, or knee on the same side. Sometimes there isn’t hip pain but just groin, thigh, or knee pain. […] Painful weight bearing on the injured leg should be avoided in order to decrease pain and allow healing.

• #29 Irritable Hip Houston | Hip Injury Pearland | Perthes Disease Baytown

  https://www.fondren.com/specialties-services/hip/irritable-hip/

  Irritable hip, also known as acute transient synovitis, is a common disorder of childhood characterized by onset of hip pain and limping. The exact cause of irritable hip is unknown. But in some cases, the condition can occur because of viral infection (upper respiratory tract) or a fall or injury. […] Irritable hip can also occur because of Perthes disease, a condition where the head of the thigh bone deteriorates because of poor blood supply.

• #30 What Is Toxic Synovitis? Its Symptoms, Causes, and More

  https://www.webmd.com/children/what-is-toxic-synovitis

  Toxic synovitis usually goes away within one or two weeks after treatment. But if you dont take care, symptoms can last for four or five weeks. […] Toxic synovitis usually goes away on its own. It can very slightly increase your risk of Legg Calve Perthes. […] Toxic synovitis has a 5-15% recurrence rate. So, it is important to follow the doctor’s instructions to heal completely.

• #31 Review for the generalist: evaluation of pediatric hip pain | Pediatric Rheumatology | Full Text

  https://ped-rheum.biomedcentral.com/articles/10.1186/1546-0096-7-10

  Transient synovitis recurs in up to 15% of children, and may affect the same or opposite hip. […] Children with septic arthritis appear ill and early management with surgical drainage and intravenous antibiotics is necessary to prevent bony destruction and preserve hip function. […] A septic hip is a surgical emergency. […] Septic arthritis is rare if there are less than 25,000 white blood cells per mm3 or less than 75% polymorphonuclear cells. […] A variety of clinical, laboratory, and radiographic criteria are used to help differentiate septic arthritis from transient synovitis, but because of the substantial overlap between the two groups there are no absolute criteria for definitive diagnosis of either condition. […] The four independent multivariate clinical predictors to differentiate between septic arthritis and transient synovitis are: history of fever, non-weight-bearing, erythrocyte sedimentation rate of at least 40 millimeters per hour, and serum white blood-cell count of more than 12,000 cells per mm3.

• #32 Irritable Hip (Transient Synovitis :: Blackpool Teaching Hospitals

  https://www.blackpoolteachinghospitals.nhs.uk/patients/patient-leaflets/PL1509

  Irritable hip, also called transient synovitis, is the most common cause of hip pain in children. It is most likely to happen between the ages of 3 and 10 years. […] The cause is unknown it is likely caused by inflammation (not infection) of the hip joint. It often happens after viral illness such as sickness and diarrhoea, the common cold, or a sore throat. […] There are normally no long-term issues following an episode of irritable hip, but 1 in 10 children may get it again in the future.

• #33 Transient Synovitis of the Hip | Doctor – PMM

  https://www.pmmonline.org/doctor/limping-child/key-conditions/hip-disorders/transient-synovitis-of-the-hip/

  Transient synovitis, also known as irritable hip, is a common cause of acute hip pain in young children. It is a self-limiting condition, but is a diagnosis of exclusion and especially to exclude septic arthritis. It is more common in boys, and tends to present in ages 4-8. It is sometimes preceded by a virus, such as gastroenteritis or a viral upper respiratory tract infection. […] It is imperative to exclude infection of the bone or joint. Septic arthritis is more likely if the child is unwell, febrile (above 38) and there are raised inflammatory markers and white cell count. […] Kocher’s rules can be helpful to differentiate septic arthritis at the hip joint from transient synovitis. It is noteworthy however that Kocher’s rules are not universally used (e.g., are not used in New Zealand) and are not useful to differentiate sepsis from acute rheumatic fever (ARF).

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