Toxic synovitis is a condition affecting children that causes hip pain and limping.
Synovitis - toxic; Transient synovitis
Causes, incidence, and risk factors
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 may include:
- Hip pain (on one side only)
- 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.
Signs 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
- C-reactive protein (CRP)
- Complete blood count (CBC)
Other tests that may be done to rule out other causes of hip pain:
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.
The hip pain goes away within 7 - 10 days.
Toxic synovitis goes away on its own. There are no expected long-term complications.
Calling your health care provider
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
Hosalkar HS, Horn D, Friedman JE, Dormans JP. The hip. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 677.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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