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Toxic synovitis

Toxic synovitis is a condition affecting children that causes hip pain and limping.

Causes

Toxic synovitis occurs in children before puberty. It is a type of arthritis of the hip. Its cause is not known. Boys are affected more often than girls.

Symptoms

Symptoms may include:

  • Hip pain (on one side only)
  • Limp
  • Thigh pain, in front and toward the middle of the thigh
  • Knee pain
  • Low-grade fever, less than 101°F (38.33°C)

Aside from the hip discomfort, the child does not usually appear ill.

Exams and Tests

Toxic synovitis is diagnosed when other, more serious conditions have been ruled out, such as:

Tests used to diagnose toxic synovitis include:

Other tests that may be done to rule out other causes of hip pain:

Treatment

Treatment often includes limiting activity to make the child more comfortable. But, there is no danger with normal activities. The health care provider may prescribe nonsteroidal anti-inflammatory medicines (NSAIDS) to reduce pain.

Outlook (Prognosis)

The hip pain goes away within 7 to 10 days.

Possible Complications

Toxic synovitis goes away on its own. There are no expected long-term complications.

When to Contact a Medical Professional

Call for an appointment with your child's provider if:

  • Your child has unexplained hip pain or a limp, with or without a fever
  • Your child has been diagnosed with toxic synovitis and the hip pain lasts for longer than 10 days, the pain gets worse, or a high fever develops

Alternative Names

Synovitis - toxic; Transient synovitis

References

Horowitz R. Pediatric orthopedic emergencies. In: Adams JG, ed. Emergency Medicine: Clinical Essentials. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 25.

Sankar WN, Horn BD, Wells L, Dormans JP. The hip. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 678.

Update Date 7/13/2015

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