Transient synovitis of the hip

Royal Childrens Hospital Royal Childrens Hospital, 2007 Taylor, 1994 Taylor, 1995

Transient synovitis of the hip, or irritable hip, is a mild, self-limiting, unilateral condition that occurs in children aged 3 to 8 years. Patients present with hip or groin pain and limp, and hip abduction and internal rotation are limited. Occasionally, patients may refuse to weightbear. Patients are afebrile and appear well; they may have a history of recent upper respiratory tract infection.

Patients with irritable hip have normal X-ray findings, full blood count and erythrocyte sedimentation rate (ESR). However, a hip X-ray may be useful to exclude any bony pathology, and ultrasound may be useful to confirm hip effusion.

Symptoms of irritable hip and septic arthritis overlap; if there is any doubt about the diagnosis, seek urgent orthopaedic review.

Note: Symptoms of irritable hip and septic arthritis overlap; if there is any doubt about the diagnosis, seek urgent orthopaedic review.

Management involves rest and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation. With NSAID use, symptoms usually improve significantly over 24 to 48 hours and generally resolve within a week.

Note: NSAIDs improve the symptoms of transient synovitis of the hip significantly over 24 to 48 hours.

If an oral NSAID are required for pain associated with transient synovitis, use:

ibuprofen immediate-release 5 to 10 mg/kg (for overweight children, use ideal body weight) up to 400 mg orally, 8-hourly until symptoms subside¹. ibuprofen ibuprofen ibuprofen

¹ This drug is available as a capsule and liquid suspension.Return