Self‐limiting inflammation of the synovium of a joint, most commonly the hip

Aetiology

• Commonly occurs shortly after an upper respiratory tract infection (usually viral) although sometimes no cause is found
• Typical age is between 2 and 10
  • Commonest cause of hip pain in childhood
• Boys are more commonly affected than girls

Clinical features

• Limp/reluctance to weight bear on the affected side
• Range of motion may be restricted
• May be low grade fever but child is not systemically unwell

Investigations

• Imaging:
  • X-ray: to exclude Perthes disease
  • MRI: rule out osteomyelitis of the proximal femur
• Bloods: if CRP normal/near normal can exclude septic arthritis
• If uncertainty between transient synovitis and septic arthritis - aspiration of the hip or open surgical drainage

Management

• NSAIDs and rest
• Pain generally resolves within a few weeks but if there is no resolution then another cause for hip pain should be sought