Transient synovitis ('irritable hip')

Intro

Clinical features

Investigations

Management

most common cause of acute hip pain in children

usually 2-12 y/os

often accompanies/after viral infection

sudden onset hip pain

limp

no pain @ rest

decreased ROM esp int rotation

may be referred to knee

afebrile/mild fever

appears well

can be difficult to differentiate from early septic arthritis of hip

if any suspicion of septic arthritis must do joint aspiration + blood cultures

3% go on to develop Perthes disease

bed rest

rarely skin traction

usually resolves in under 1 wk

non-weight bearing

normal WCC

normal/only slightly increased CRP/ESR

US shows fluid in joint

X-ray normal

analgesia