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Toxic synovitis

Definition

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

Alternative Names

Synovitis - toxic; Transient synovitis

Causes

Toxic synovitis occurs in children before puberty. It usually affects children from 3 to 10 years old. It is a type of inflammation 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 drugs (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

References

Sankar WN, Winell JJ, Horn BD, Wells L. The hip. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 698.

Singer NG. Evaluation of children with rheumatologic complaints. In: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 105.


Review Date: 7/7/2019
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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