 Toxic synovitis
Definition Alternative Names Causes, incidence, and risk factors Symptoms Signs and tests Treatment Expectations (prognosis) Complications Calling your health care provider References DefinitionToxic synovitis is a condition affecting children that causes hip pain and limping. Alternative NamesSynovitis - toxic; Transient synovitis Causes, incidence, and risk factorsToxic synovitis occurs in children before puberty begins. It is a type of arthritis of the hip. Its cause in not known, but boys are affected more often than girls (approximately 4 to 1). SymptomsSymptoms 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° Fahrenheit
Aside from the hip discomfort, the child does not usually appear ill. Signs and testsToxic synovitis is diagnosed when other, more serious conditions have been ruled out, such as: - Septic hip
- Slipped capital femoral epiphysis
- Legg-Calve-Perthes disease
Tests used to diagnose toxic synovitis include: - Ultrasound of the hip
- X-ray of the hip
- ESR
- C-reactive protein (CRP)
- Complete blood count (CBC)
Other tests that may be done to rule out other causes of hip pain: TreatmentTreatment often includes limiting activity to make the child more comfortable. However, there is no danger with performing normal activities. The health care provider may prescribe nonsteroidal anti-inflammatory medications (NSAIDS) to reduce pain. Expectations (prognosis)The hip pain goes away within 7 - 10 days. ComplicationsToxic synovitis goes away on its own. There are no expected long-term complications. Calling your health care providerCall for an appointment with your child's health care 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
ReferencesHosalkar HS, Horn D, Friedman JE, Dormans JP. The Hip. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 677.
Review Date: 11/2/2009
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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