Is your child limping?
Has your child suddenly been complaining of pain and is unwilling to bear weight or has started to limp, if so then most likely the cause may be transient synovitis a.k.a irritable hip.
Transient synovitis is the most common cause of pediatric hip pain yet much is unknown about the condition, it is usually a benign self-limiting process that gets better on its own within 1-2 weeks and is most often affecting children aged 1-3 years.
How to figure out if the child has an irritable hip?
Typically presents with sudden onset of thigh or groin pain and a limp or refusal to bear weight, the child may lie with hips bent and spaced apart.
What causes transient synovitis?
The exact cause is still unknown however there appears to be an association of transient synovitis with viral infection. It leads to inflammation of the joint lining causing the fluid that is normally present to increase in volume thus causing the limp and pain.
Should you be worried about transient synovitis?
Transient synovitis on its own is a self-limiting condition but there are several other conditions that may mimick irritable hip, some of them potentially devastating that if not diagnosed or treated in time may lead to irreversible damage to the joint, thus the diagnosis of transient synovitis as a cause of hip pain is mainly that of exclusion. Some of the other related conditions include
- Septic arthritis
- Juvenile rheumatoid arthritis
- Slipped capital femoral epiphysis
- Perthes disease
Are there any investigations for transient synovitis of the hip?
As mentioned earlier it is important to exclude other serious causes of hip pain and this is the main focus of investigations.
Lab investigations such as CBC, ESR, and CRP along with ultrasound of the involved hip are usually carried out before making the diagnosis of transient synovitis.
How is transient synovitis treated?
It usually resolves spontaneously and is managed by encouraging rest and observing the child. The child may be prescribed NSAIDs such as ibuprofen in conjunction.
When to seek medical advice?
o If the child has a fever of more than 38C
o Persistent limp/pain for more than 2 weeks.
o Child not wanting to eat or drink, sleeping more.
o If there is swelling, redness, or pain in any other joint.
What to expect in a case of irritable hip?
Transient synovitis would resolve on its own usually in 2-3 days and does not cause any long-term problems of the hip joint.
It may be noted though that there may be an increased likelihood of recurrence, especially within the first two years.