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Toxic synovitis
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Toxic synovitis

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Synovitis - toxic; Transient synovitis

Toxic synovitis is a condition affecting children that causes hip pain and limping.

I Would Like to Learn About:

  • Causes

    Toxic synovitis occurs in children before puberty begins. It is a type of arthritis of the hip. Its cause is not known, but boys are affected more often than girls (approximately 4 to 1).

  • Symptoms

    Symptoms may include:

    • Hip pain (on one side only)
    • Limp
    • Thigh pain, in front and toward the middle of the thigh
    • Knee pain
    • Low-grade fever, less than 101° Fahrenheit

    Aside from the hip discomfort, the child does not usually appear ill.

  • Exams and Tests

    Toxic synovitis is diagnosed when other, more serious conditions have been ruled out, such as:

    • Septic hip
    • Slipped capital femoral epiphysis
    • Legg-Calve-Perthes disease

    Tests used to diagnose toxic synovitis include:

    • Ultrasound of the hip
    • X-ray of the hip
    • ESR
    • C-reactive protein (CRP)
    • Complete blood count (CBC)

    Other tests that may be done to rule out other causes of hip pain:

    • Aspiration of fluid from the hip joint
    • Bone scan
    • MRI
  • Treatment

    Treatment often includes limiting activity to make the child more comfortable. However, there is no danger with performing normal activities. The health care provider may prescribe nonsteroidal anti-inflammatory medications (NSAIDS) to reduce pain.

  • Outlook (Prognosis)

    The hip pain goes away within 7 - 10 days.

  • Possible Complications

    Toxic synovitis goes away on its own. There are no expected long-term complications.

  • When to Contact a Medical Professional

    Call for an appointment with your child's health care provider if:

    • Your child has unexplained hip pain or a limp, with or without a fever
    • Your child has been diagnosed with toxic synovitis and the hip pain lasts for longer than 10 days, the pain gets worse, or a high fever develops

Related Information

  Hip painArthritisFever     Osteoarthritis

References

Sankar WN, Horn BD, Wells L, Dormans JP. Transient monoarticular synovitis (toxic synovitis). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 670.

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Review Date: 8/22/2013  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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