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 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. […] Unilateral hip or groin pain is the most common symptom reported; however, some patients with transient synovitis may report medial thigh or knee pain. […] Children with transient synovitis are usually afebrile or have a mildly elevated temperature; high fever is rare. […] 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.

• #3 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. […] 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.

• #4 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.

• #5 Transient synovitis (irritable hip) — Chelsea and Westminster Hospital NHS Foundation Trust

  https://www.chelwest.nhs.uk/your-visit/patient-leaflets/paediatrics/transient-synovitis-irritable-hip

  Irritable hip occurs when the membrane becomes inflamed for a short period of time (otherwise known as transient synovitis). […] The inflammation causes pain. […] Irritable hip occurs in children (usually aged between 3 and 10 years) and is more common in boys than girls. […] Unfortunately no one knows the cause. It may be due to a virus, or perhaps a reaction to an infection somewhere else in the body. […] The inflammation in the joint sometimes happens after a flu-like illness. […] One of the most important of these is a bacterial infection in the hip, which needs to be diagnosed and treated relatively quickly to prevent any damage occurring to the hip joint. […] An anti-inflammatory medicine, such as ibuprofen may be recommended to ease the swelling of the synovial membrane.

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

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

  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. […] It is a benign condition with a small amount of fluid in the joint. […] 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. […] It can be managed with oral analgesics and observation. […] A septic hip is a surgical emergency. […] Perthes’ disease is an idiopathic avascular necrosis/osteonecrosis of the femoral epiphysis (usually affecting those aged 4-10 years and peaking between 5 and 7 years). […] SCFE is displacement of the proximal femoral epiphysis off the femoral neck, usually in those aged 11-14 years.

• #7 Irritable Hip Atlanta | Acute Transient Synovitis | Hip Limping Georgia

  https://www.jonhymanmd.com/irritable-hip-jonhyman.html

  Irritable hip, also known as acute transient synovitis, is a common disorder of childhood characterized by onset of hip pain and limping. The term transient means that it does not usually last long. It usually occurs before puberty and affects only one hip. Boys aged between 4 to 10 years are most often affected 2 to 4 times more than girls. […] The exact cause of irritable hip is unknown. But in some cases, the condition can occur as a result of viral infection (upper respiratory tract) or a fall or injury. Irritable hip can also occur as a result of Perthes disease, a condition where the head of the thigh bone deteriorates because of poor blood supply. […] The treatment of irritable hip includes medications and bed rest. Painkillers or anti-inflammatory drugs (called NSAIDS) are prescribed to help relieve pain and reduce inflammation. Your doctor may prescribe some specific medications depending on the type of infection detected in the child. Applying heat and massaging the affected hip may also help in reducing hip pain.

• #8 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. […] Although the condition is benign and self-limiting, providers must recognize the critical importance of differentiating transient synovitis from acute infectious processes. […] The pathoanatomy underlying transient synovitis is relatively nonspecific. The proposed pathologic cascade entails nonspecific inflammation targeting the synovial joint lining causing hypertrophic changes. […] The acute inflammatory phase clinically manifests as a pain that is self-limiting and resolves within 24 to 48 hours. […] The natural history favors a complete resolution of symptoms within 1 to 2 weeks, although recurrence rates can be as high as 20%. […] 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.

• #9 Transient synovitis of the hip | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/transient-synovitis-of-the-hip?lang=us

  Transient synovitis of the hip refers to a self-limiting acute inflammatory condition affecting the synovial lining of the hip. It is considered one of the most common causes of hip pain and limping in young children. Over 90% of hip joint effusions in children tend to be due to transient synovitis. […] Their exact pathogenesis is not well known. Several theories have been proposed. In some situations, it may follow an upper respiratory tract infection. Some have suggested a viral etiology; potentially related to Parvovirus B19 and/or herpes simplex virus 6 infections. Others have proposed a post-traumatic etiology with subsequent development of chemical synovitis. […] It is a self-limiting disorder that usually has no residual sequelae. Recurrence is possible. Management is usually supportive.

• #10 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. […] The inflammation in the hip may be an allergic reaction that occurs when the immune system responds to infection elsewhere in the body. […] A child may experience physical trauma before the symptoms of irritable hip become clear. […] Sedimentation is the process through which red blood cells separate from blood serum, and it is part of the inflammation mechanism. The body sends out C-reactive protein in response to inflammation, which is why increased rates occur with irritable hip symptoms. […] The primary modalities of treatment consist of rest and the use of nonsteroidal anti-inflammatory medication, such as ibuprofen or naproxen, or a pain reliever such as acetaminophen.

• #11

  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. […] 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, or allergic reaction. […] Pathophysiology includes non-specific inflammation and hypertrophy of the synovial lining/membrane. […] If symptoms improve with NSAIDS, more likely to be transient synovitis. […] Natural history of disease is usually benign with marked improvement, usually in 24-48 hours, and complete resolution of symptoms will usually occur in 1-2 weeks.

• #12 Irritable Hip Baltimore | Acetabular Fracture Salisbury | Trochanteric Bursitis Bethesda

  https://www.tariqnayfehmd.com/irritable-hip-orthopedic-surgeon-silver-spring-rockville-md/

  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. […] The treatment of an irritable hip includes medications and bed rest. Painkillers or anti-inflammatory drugs (NSAIDs) are prescribed to help relieve pain and reduce inflammation.

• #13 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.

• #14 Toxic synovitis in children and adults: What to know

  https://www.medicalnewstoday.com/articles/322163

  Toxic synovitis, also called transient synovitis or irritable hip, is a condition that causes inflammation and pain in the hip. It primarily affects children. […] Toxic or transient synovitis is a temporary condition that causes pain and inflammation of a joint, almost always in the hip. It usually affects children. […] Toxic synovitis primarily affects children, and it may also occur in adults. However, adult cases are rare and have not been documented well. […] The condition is most common in children between the ages of 3 and 8. […] Toxic synovitis is more prevalent in boys than girls. […] Doctors are still uncertain about the exact cause of toxic synovitis, but it often occurs following a viral infection, such as those that cause diarrhea or a cold. […] Because of this, there is a suspicion that the child’s immune system creates something while fighting the infection that then causes toxic synovitis. […] Toxic synovitis causes no long-term complications. However, some children develop it multiple times. […] A child with toxic synovitis who receives basic treatment will usually make a full recovery within 2 weeks. […] Adults are unlikely to develop toxic synovitis.

• #15 Is your child complaining of hip pain? It could be one of these – Jupiter Hospital

  https://www.jupiterhospital.com/pune/blog/is-your-child-complaining-of-hip-pain-it-could-be-one-of-these/

  Transient synovitis – Commonly referred to as irritable hip, it is a condition marked by severe inflammation of the synovium, the soft tissue that lines the hip joint. The problem affects nearly 3% of the children lying in the age group of 3 to 10 years. A child suffering from the condition experiences extreme hip pain and may even limp due to the inability of the affected joints to bear any weight. […] Hip dysplasia – The condition is marked by a structural deformity in the ball and socket joint of the hip which is present since birth. In simple terms, the socket of the hip joint is smaller as compared to the ball of the femur, and as such, the latter is not able to completely cover the former, as it normally should. […] Juvenile idiopathic arthritis – You must have heard about arthritis in adults but did you know that children can have arthritis too? Yes, you read that right. Juvenile idiopathic arthritis happens to be the most common type of arthritis that affects children below 16 years of age.

• #16 Irritable hip (transient synovitis) – GPnotebook

  https://gpnotebook.com/pages/paediatrics/irritable-hip

  Irritable hip – more accurately known as transient synovitis – is a common disorder of childhood which presents with the acute onset of hip pain and a limp that gradually resolves. The cause is uncertain and the condition is usually made as a diagnosis of exclusion. […] Infection and trauma are postulated as precipitating factors but prospective studies report infection, usually of the upper respiratory tract, in only 30% of cases, and significant trauma in only 5% of cases. […] Boys between two and twelve years of age appear to be the most susceptible group.

• #17 Irritable hip and perthe’s disease | PPT

  https://www.slideshare.net/slideshow/irritable-hip-and-perthes-disease/65829978

  The hip may be painful with passive movement and tender to palpation. The most sensitive test for transient synovitis is the log roll, in which the patient lies supine and the examiner gently rolls the involved limb from side to side. This may detect involuntary muscle guarding of one side when compared to the other side. […] 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. […] Legg-Calv-Perthes disease (LCPD) is the name given to idiopathic osteonecrosis of the capital femoral epiphysis in a child.

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

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

  The possible etiologic relationship between transient synovitis and Legg-Calv-Perthes disease (LCP) is controversial. […] Although some children with transient synovitis may develop LCP, whether persistence of increased intraarticular pressure eventually causes avascular necrosis or whether patients may have a synovitis that occurs before detection of femoral head collapse is not fully known.

• #19 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 an acute inflammatory condition of the inner lining of the hip. […] Transient synovitis is also known as toxic synovitis or irritable hip. […] 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). […] There is much debate about a possible link between transient synovitis and another condition called Legg-Calve-Perthes disease. […] Only a small number of children with transient synovitis develop Legg-Calvé-Perthes disease. […] It’s possible the prolonged increase in pressure inside the joint causes loss of blood supply to the hip. […] Inflammation and effusion (swelling) can cause sudden hip pain. […] The child may refuse to walk or may limp when walking as the first sign of a problem.

• #20 Is your child complaining of hip pain? It could be one of these – Jupiter Hospital

  https://www.jupiterhospital.com/pune/blog/is-your-child-complaining-of-hip-pain-it-could-be-one-of-these/

  Legg-calve-Perthes Disease – It is a condition marked restricted supply of oxygenated blood to the ball part of the hip joint, due to which the bone starts to deteriorate. This is commonly referred to as avascular necrosis. The condition is rare and progresses through various stages over a span of years.

• #21 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

  The painful symptoms may travel to the thigh, groin, or knee on the same side. […] Your child may want to keep the hip and leg in a resting position of flexion (bent), external rotation (turned outward), and abduction (away from the other leg). […] The history and physical examination are probably the most important tools used to diagnose transient synovitis of the hip. […] The majority of patients will be referred to a doctor for further diagnostic tests such as an X-ray, an ultrasound, and/or blood tests that can help to confirm or rule out the diagnosis. […] The main goal of treatment for transient synovitis of the hip in children is to decrease the pain and maintain hip range of motion. […] Painful weight bearing on the injured leg should be avoided in order to decrease pain and allow healing. […] Surgery is not usually necessary.

• #22 Irritable hip and perthe’s disease | PPT

  https://www.slideshare.net/slideshow/irritable-hip-and-perthes-disease/65829978

  The patient may have an antalgic gait with limited hip motion. Passive range of motion is limited, especially internal rotation and abduction. […] The prognosis usually shows marked improvement within 24-48 hours, with two-thirds to three-fourths of patients having complete resolution within 2 weeks. The recurrence rate is 4-17%; most recurrences develop within 6 months.

• #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. There is a limited range of motion of the hip joint. […] 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. The recurrence rate is 417%, most of which is in the first six months.

• #24 Review for the generalist: evaluation of pediatric hip pain

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2686695/

  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. […] Transient synovitis typically has an acute onset, and spontaneous recovery with no radiological abnormality or systemic upset. […] 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. Hip aspiration is considered the gold standard for diagnosis of septic arthritis, with greater than 100,000 white blood cells per mm3 with a predominance of polymorphonuclear cells or positive gram stain and culture confirming the diagnosis.

• #25 Review for the generalist: evaluation of pediatric hip pain

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2686695/

  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 predicted probability of septic arthritis was determined for all sixteen combinations of these four predictors and is summarized (original cohort/prospective cohort) as less than 0.2 percent for zero predictors, 3.0/9.5 percent for one predictor, 40.0/35.0 percent for two predictors, 93.1/72.8 percent for three predictors, and 99.6/93.0 percent for four predictors. […] Clinical prediction rules serves as guidelines but clinical judgment ultimately dictates patient management.

• #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

  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. […] Clinical prediction rules serves as guidelines but clinical judgment ultimately dictates patient management.

• #27 Irritable Hip | UAMS Department of Radiology

  https://medicine.uams.edu/radiology/kb/irritable-hip/

  A very common sighting in any pediatric emergency department is the child who presents with refusal to bear weight, sudden limp or atypical irritability and crankiness. […] Septic arthritis, a surgical emergency, is always to be suspected when a child of any age presents with hip pain, fever, irritability and toxic appearance without a history of trauma. […] Most cases of septic arthritis occur from direct extension of bacterial infection (Staphylococcus aureus is frequently the causative organism) from the adjacent metaphysis. […] Diagnostic evaluation frequently begins with hip joint radiographs which may be unrevealing or may show widening of the joint space, which is a nonspecific finding. […] If there is an effusion on ultrasound, US guided aspiration is generally the next step to differentiate between the more critical septic arthritis and the more indolent transient synovitis.

• #28 Bilateral Irritable Hip: A Rare Presentation of Leukemia in Children

  https://brieflands.com/articles/apid-20270

  Bone pain presenting as localized bilateral irritable hip could be considered as a diagnostic clue related to malignancies. […] Pain syndromes related to hematological disorders may be due to heterogeneous mechanisms, mainly osteolysis, bone marrow (BM) infiltration, BM expansion, increased intraosseous pressure due to malignant infiltration and tumor growth, lowering of the receptor threshold by chemical mediators, and stretching of the periosteum. […] A special pattern of bone pain similar to bilateral hip pain as a primary presentation of malignancy has rarely been reported, particularly in children. […] New onset bilateral irritable hip in children without obvious symptoms of septic arthritis of the hip, as well as an association with cytopenia with acute onset bilateral irritable hip in children is a red flag in childhood bone pain. […] Because the initial presentations of patients with malignancies sometimes involve the musculoskeletal system, physicians need to recognize the symptoms of this disease to avoid misdiagnosis and to expedite the initiation of appropriate, potentially lifesaving treatment.

• #29 Irritable Hip In Children | KidsHealth New Zealand’s Trusted Voice On Children’s Health

  https://www.kidshealth.org.nz/irritable-hip-in-children

  Irritable hip is one of the most common causes of limping in tamariki (children). The medical name for irritable hip is transient synovitis. Irritable hip is not serious and your child will get better with rest and time. […] Transient synovitis is inflammation (swelling) in the lining of the hip joint. It can cause pain in the hip joint. […] No one knows exactly what causes irritable hip. It can happen in tamariki who have recently had a viral infection, but there is no infection in the hip joint itself. […] Tamariki who get irritable hip are usually between 3 to 8 years old. […] Usually only one hip is affected. […] Your child may: complain of pain in the hip, groin, thigh, or knee. […] Irritable hip is not a serious condition. You can usually look after your child at home. […] No. Tamariki who have had irritable hip do not develop long-term problems in their hips.

• #30 Physical therapy in Middleton for Pediatric Pain – Transient Synovitis

  https://www.sportsrehabu.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 an acute inflammatory condition of the inner lining of the hip. Transient means it is temporary and doesn’t last long. Transient synovitis 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. […] Inflammation and effusion (swelling) can cause sudden hip pain. Usually only one hip is involved. The child may refuse to walk or may limp when walking as the first sign of a problem. […] The main goal of treatment for transient synovitis of the hip in children is to decrease the pain and maintain hip range of motion. […] Antiinflammatory drugs will likely be prescribed along with rest from activity during the acute phase of pain.

• #31 Toxic Synovitis, or Transient Synovitis of the Hip – familydoctor.org

  https://familydoctor.org/condition/transient-synovitis-of-the-hip/

  Transient synovitis of the hip, also called toxic synovitis, is an inflammation and swelling of the tissues around the hip joint. Usually only one hip is affected. This condition is called “transient” because it lasts only a short time. Transient synovitis of the hip is the most common cause of sudden hip pain in children. […] Doctors don’t know the exact cause of transient synovitis of the hip. It might be caused by a virus or it might be from an allergic reaction to an infection somewhere else in the body. […] Your doctor will look at your child’s hip to find out what kind of movement makes the pain worse. Your doctor may order blood tests, X-rays, and an ultrasound. These tests will help your doctor make sure that the cause of hip pain isn’t caused by something more serious. […] Since doctors don’t know what causes transient synovitis of the hip, it can’t be prevented or avoided.

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

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

  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). In endemic areas for ARF, a monoarthritis is a common presentation and should be suspected with a raised ESR even if the white cell count is not elevated.

• #33 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. But it should always be checked because it could be a sign of something serious. […] 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. […] Irritable hip usually gets better in 1 or 2 weeks and does not cause lasting problems.

• #34 Toxic Synovitis, or Transient Synovitis of the Hip – familydoctor.org

  https://familydoctor.org/condition/transient-synovitis-of-the-hip/

  Rest at home is the most important way to help your child’s hip get better. Your child may need to take a nonsteroidal anti-inflammatory medicine, such as ibuprofen (brand names: Advil, Motrin), to reduce the swelling and inflammation around the hip joint. Also, your doctor may advise you to apply heat to your child’s hip. Massage may make the area to make it feel better, too. […] If the pain is still bad after 10 days, your child should be rechecked by your doctor. Your doctor may order some tests to make sure there isn’t something else wrong with your child’s hip.

• #35 Physical therapy in Reading, Sinking Spring, Wernersville, Berks county for Pediatric Pain – Transient Synovitis

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

  The main goal of treatment for transient synovitis of the hip in children is to decrease the pain and maintain hip range of motion. […] Painful weight bearing on the injured leg should be avoided in order to decrease pain and allow healing. […] Surgery is not usually necessary. In severe cases of transient synovitis children may be hospitalized for observation and leg traction.

• #36 Treatment of Transient Hip Tenosynovitis with NSAIDs | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0115/p406.html

  Transient tenosynovitis of the hip (irritable hip) is a common emergency department problem among children three to 10 years of age. Sterile joint inflammation results in pain on hip movement and may manifest as limping or inability to walk. The etiology for this condition is unclear, although an infectious cause or antecedent is commonly postulated. The authors conclude that hip tenosynovitis symptoms may resolve more quickly with the use of ibuprofen, probably secondary to the NSAID’s anti-inflammatory effects rather than its analgesic effects. Treatment with ibuprofen is safe and well tolerated.

• #37 Dr. Leo Donnan – Paediatric & Adult Orthopaedic Surgeon – Irritable Hip

  https://leodonnan.com.au/irritable-hip/

  Irritable hip (also called Transient Synovitis of the hip) involves inflammation of the lining (synovium) of the hip joint. […] It is the most common cause of hip pain in children and a common cause of limping. […] The exact cause of an irritable hip is unknown, however, it may be related to an infection (such as an upper respiratory viral infection) or trauma. […] An irritable hip will be diagnosed once other more serious conditions are excluded, your child will require an x-ray of their pelvis and hip. […] Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can relieve pain and inflammation and can be useful to manage the symptoms of an irritable hip. […] For most children, an irritable hip is a short-term problem and your child is most likely to make a full recovery.

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