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. Although the condition is usually transitory, it may lead to Osteoarthritis in the later stages of life or may recur in case the child acquires infection.
Causes
- 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
Symptoms
- Pain in the hip, legs, thigh, groin and knee
- Change in gait as the child tends to develop a limp
- Infants may find it difficult to crawl
- The condition mostly affects one side of the hip
- The pain may develop as a mild ache and progress slowly to be severe. In other cases, there may be a sudden onset of severe hip pain
- Resting in a certain position may become particularly painful
- A catching or locking sensation may be experienced while walking
- Weight bearing may become difficult for some patients
- Some children may also have low grade fever
Diagnosis
- Detailed physical examination of the joint to check for movements that cause pain
- Palpation may be done to check if the hip is tender
- A complete detailed examination of the muscuo-skeletal system of the body to check if there is inflammation in other joints
- Log Roll- This test is done by making the patient lie in a supine position and then roll from one side to the other
- Urine analysis
- Blood tests to check for white blood cell count
- X-ray examination of the hip joint
- Ultrasound or MRI may be conducted to check the condition of the soft tissue structures
- A sample of the synovial fluid may be drawn through aspiration and tested in a laboratory
- Bone scan may be required in some cases
Treatment
- Pain killers and anti inflammatory medicines may be prescribed to relieve the symptoms
- Heat therapy may be used to provide relief
- Bed rest for 7 to 10 days or till complete recovery may be recommended
- Physical activities like sports that pressurize the hip joint should be avoided to allow complete recovery.