Transient synovitis of the hip

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 10.

It typically affects young children (3-8 year olds). There is a recognised increased male predilection.

Patients typically present with hip pain for one to three days, associated with limping or the refusal to bear weight. 

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 aetiology (e.g. related to Parvovirus B-19 and /or Herpes simplex virus 6 infections while others have proposed a post-traumatic aetiology with subsequent development of chemical synovitis.

Features are nonspecific although in some cases there may be an increase in medial joint space in the affected hip 5.

Useful at demonstrating a joint effusion which is often seen in the anterior recess. Herniation of the synovial membrane through a joint capsular defect (pseudodiverticulum) between the iliopsoas muscle and the anterior border of the joint capsule may be seen in a very small proportion of patients (~2%) 1.

Described features include 6

It is a self-limiting disorder usually has no residual sequelae. Recurrences are possible. Management is usually supportive.

For imaging appearances, possible considerations include

For clinical limping there can be much wider differential such as other childhood arthritides (e.g. juvenile rheumatoid arthritis 1Brucellar arthritis), Perthes disease, epiphysiolysis and osteoid osteoma etc.

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Article information

rID: 33112
Section: Pathology
Synonyms or Alternate Spellings:
  • Transient synovitis of the hips
  • Transient synovitis of hip
  • Transient synovitis of hips
  • Transient hip synovitis

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