Toxic synovitis is a condition affecting children that causes hip pain and limping.
Synovitis - toxic; Transient synovitis
Toxic synovitis occurs in children before puberty begins. It is a type of arthritis of the hip. Its cause is not known, but boys are affected more often than girls (approximately 4 to 1).
Symptoms may include:
- Hip pain (on one side only)
- 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.
Exams and Tests:
Toxic 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
- C-reactive protein (CRP)
- Complete blood count (CBC)
Other tests that may be done to rule out other causes of hip pain:
Treatment 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.
The hip pain goes away within 7 - 10 days.
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 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
Sankar WN, Horn BD, Wells L, Dormans JP. Transient monoarticular synovitis (toxic synovitis). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 670.
|Review Date: 8/22/2013|
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, Bethanne Black, and the A.D.A.M. Editorial team.
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