TRANSIENT SYNOVITIS OF THE HIP IN CHILDREN

Transient synovitis is the most common cause of acute hip pain in chil dren three to 10 years of age. Children with this condition typically present with hip pain for one to three days, accompanied by limping or the refusal to bear weight. Transient synovitis has an uncertain etio logy and remains a diagnosis of exclusion. First, septic arthritis mus t be ruled out, since femoral head destruction, degenerative arthritis and permanent deformity can occur if septic arthritis is not treated promptly. Septic arthritis should be suspected in a patient with sever e pain or spasm on hip movement or palpation, a temperature higher tha n 37.5 degrees C (99.5 degrees F) and an erythrocyte sedimentation rat e of 20 mm per hour or greater. Hip aspiration is the diagnostic proce dure of choice ii septic arthritis is suspected. Treatment of transien t synovitis consists of bed rest and nonsteroidal anti-inflammatory dr ugs, with regular temperature checks to exclude the onset of fever. If significant pain and limping persist seven to 10 days after the initi al presentation, the patient should be reevaluated.