Toxic synovitis

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

  • Alternative Names
    • Synovitis - toxic; Transient synovitis

  • Causes
    • Toxic synovitis occurs in children before puberty. It is a type of arthritis of the hip. Its cause is not known. Boys are affected more often than girls.

  • 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°F (38.33°C)

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

  • Exams and Tests
  • Treatment
    • Treatment often includes limiting activity to make the child more comfortable. But, there is no danger with normal activities. The health care provider may prescribe nonsteroidal anti-inflammatory medicines (NSAIDS) to reduce pain.

  • Outlook (Prognosis)
    • The hip pain goes away within 7 to 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 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
  • References
    • Horowitz R. Pediatric orthopedic emergencies. In: Adams JG, ed. Emergency Medicine: Clinical Essentials. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 25.

      Sankar WN, Horn BD, Wells L, Dormans JP. The hip. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 678.