Transient Synovitis in Children
Download as PPTX, PDF9 likes4,704 views
The document discusses irritable hip syndrome, characterized by transient synovitis leading to hip pain and limping, typically lasting 1-2 weeks. Diagnosis is primarily clinical, supported by imaging and blood tests to rule out serious conditions. Management includes symptomatic care, rest, and monitoring, with a generally good prognosis despite potential for recurrence.
Transient Synovitis in Children
- 1. PRESENTED BY: ANISH DHAKAL (ARYAN) 26TH MARCH, 2019
- 4. Introduction The Irritable Hip A non-specific, short lived synovitis Transient – last for 1-2 weeks then subside Results in effusion of hip joint Most common cause of acute limping or hip pain
- 5. Aetiology Exact cause not known Viral infections, trauma and allergy Leads to synovial effusion Increased intra-articular pressure
- 6. Clinical Features Pain – groin region, front of thigh, sometimes up to knee Limping, crying Symptoms occur – intermittently or after activity History of sore throat, cough, ear infection prior to limp pain O/E: ◦ Slight wasting may appear ◦ Restriction of all movements mostly at the extremes of the movement ◦ Tenderness at the joint
- 7. How to diagnose? Mostly based on clinical features Investigations – mostly done to rule out serious conditions 1. CBC, ESR, CRP : usually normal or may be raised 2. X-ray : increased joint space as compared to unaffected side 3. USG : effusion (capsular distention) and subluxation of femoral head may appear
- 10. Ultrasonography Figure 1 Patient with transient synovitis: sagittal US image. The anterior (A) and posterior (P) layers of the joint capsule are separated by anechoic effusion. Figure 2 A healthy child. US image of the anterior joint shows the femoral neck, the iliopsoas muscle and both layers of the anterior joint capsule(arrow)
- 12. Management Symptomatic ◦ Bed Rest ◦ Decrease activity of the joint ◦ Traction – might increase intra-articular pressure ◦ Joint Aspiration – symptoms relieve but is short-lived Mostly symptoms resolves within few days Weight bearing only after effusion disappears Good prognosis but repeated episodes may occur
- 14. References Solomon, Warwick, Nayagam; Appley’s System of Orthopedics and Fractures, 9th Ed Essential Orthopedics. 5th Edition