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Transient synovitis (irritable hip) (Diagnosis (History (DH Meds,…
Transient synovitis
(irritable hip)
Definition
Orthopedic disorder
causing hip pain in children
Epidemiology
Commonest cause of
hip pain in children
Age 2-12y
Pathophysiology
Defect
Post-infectious
Mechanism
Post-viral reactive inflammation
in the hip joint, causing pain
Clinical
presentation
Limp
Pain in hip
Diagnosis
Examination
Musculoskeletal exam
Antalgic gait
Reduced ROM (internal rotation)
Investigations
Bloods
FBC, CRP/ESR (nil)
Blood cultures (nil)
Imaging
Hip USS (nil)
Hip X-radiograph (nil)
Bedside
Obs (nil)
Measurements (weight, BMI)
Joint aspiration
MCS (r/o septic arthritis)
History
DH
Meds, allergies
FH
Hip disorders,
orthopedic problems
PMH
Growth and development
Known medical conditions
PC/HPC
Acute hip pain or limp
Preceeding infection e.g. URTI
SH
Living arrnagements, school,
activity, diet
Management
Initial ABCDE
Definitive
Conservative
Information, advice, support
Lifestyle (rest)
Medical
Analgesia
Indication: pain
E.g. ibuprofen, paracetamol
Complications
Perthe's disease
Transient synovitis preceeds
Perthes in some children