Transient synovitis of the hip, also called toxic synovitis is a self limiting disorder, where the inner lining of the capsule of hip joint is inflamed. Children from 3 to 10 years usually suffer from this disorder.
Transient synovitis of the hip in adults is very rare, it is a diagnosis of exclusion, that means before coming to conclusion of transient synovitis, all the other possibilities of hip pain in adults should be excluded.
In adults the differential diagnosis may be avascular necrosis of hips, hair line fracture of the hip, any infection such as septic arthritis, tuberculous effusion and arthritis of hip joint, psoas abscess, gonococcal arthritis, testicular disease etc
The cause of transient synovitis is not known, but it is often precipitated after viral upper respiratory tract infection in children.
The Symptoms of Transient Synovitis in Hip are
- Acute pain in the hip (one side only).
- Difficulty in walking.
- Limping can be mild to severe.
- Mild rise in temperature.
- Passive and active movement is painful.
- Hip is tender on palpation.
- Pain in the inner thigh and knee of the affected limb.
Symptoms of transient synovitis of knee are similar as in hip joint. There is pain in the knee and the thigh of the affected limb. Slight rise in temperature is noted, with limping gait. The knee joint is tender to touch and single knee is affected at a time.
Test for Transient Synovitis in Adults
As said earlier, transient synovitis of the hip in adults is usually not found, in such circumstances the tests are important tool for differential diagnosis of other serious disease affecting the hip joint in adults.
White cell count, ESR, and C- reactive proteins when raised markedly, than other more serious causes such as septic arthritis have to be kept in mind in case of adults.
Positive RA test will indicate rheumatic arthritis. Further evaluation may be necessary.
X-ray of hip will help to rule out occult fractures and bony tumors in adults.
Needle aspiration with the aid of ultrasound is necessary if there is doubt of septic focus. The fluid of transient synovitis is clear watery while the fluid in septic arthritis is full of pus.
Treatment of Transient Synovitis
It is a self limiting disease and after necessary treatment, the disease resolves within few days or a week.
Hot fomentation at the site of pain, mild massage is useful.
Medications such as NSAID’s relieve the pain and inflammation of the synovial membrane.
Rest in bed is necessary for few days.
Patient should not bear extra weight on the affected limb.