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Transient Hip Synovitis, 146 Cases, Origin and Duration
Hartmut Gaulrapp1, Philipp Schoof2, Gregor Schönecker3
1Facharztpraxis für Orthopädie und Kinderorthopädie München-Schwabing, München, Germany.
Insights
Transient hip synovitis, a common pediatric orthopedic condition, typically resolves within 19 days. Viral infections and physical exertion are frequent triggers in children, with hip pain and effusion noted on ultrasound.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Imaging
- Pediatric Infectious Diseases
Background:
- Transient hip synovitis is a prevalent pediatric orthopedic condition.
- Understanding its origins, clinical presentation, and resolution is crucial for effective management.
Purpose of the Study:
- To investigate the incidence, origins, clinical findings, imaging characteristics, and symptom duration of transient hip synovitis in children.
- To differentiate transient hip synovitis from other pediatric hip pathologies.
Main Methods:
- A non-controlled interventional study involving 146 pediatric patients diagnosed with transient hip synovitis via ultrasound.
- Data collection included patient history, clinical examination, ultrasound findings, and follow-up for symptom and effusion duration.
Main Results:
- The incidence of transient hip synovitis was 0.53% among pediatric patients.
- Common triggers included viral infections (41.0%), physical exertion (21.6%), and trauma (15.1%).
- Ultrasound revealed joint effusion in all patients, resolving within an average of 19.1 days, with clinical symptoms resolving slightly earlier.
Conclusions:
- Transient hip synovitis is a common pediatric hip condition with identifiable triggers and predictable resolution patterns.
- Ultrasound is effective in diagnosing joint effusion, and symptom duration is relatively short, aiding in clinical management decisions.
Abstract:
Transient hip synovitis is one of the most common paediatric orthopaedic diseases. This non-controlled interventional study investigated the origin, clinical findings, imaging and the duration of symptoms. 146 affected patients out of the total of 27659 patients under 18 years result in an incidence of 0.53%. 76.7% boys outweighed 23.3% girls (1.8-12.9 years [Ø 6.3 y, boys Ø 6.5 y, girls Ø 6.2 y]). Diagnoses were defined by ultrasound and the absence of concurrent diseases. In 60.5% of patients, the right hip was affected, in 39.5% the left. A single patient had CF on both sides but not at the same time. No simultaneous incidence was recorded. There were two singular recurrences. Within the study period, we counted 11 cases of Perthes' disease, 2 juvenile hip arthritis and one septic hip. Patients' history showed 41.0% viral infections, 21.6% physical exertion and 15.1% singular trauma. In 22.3% no origin could be named. Clinical aspects included pain in inward rotation (51.5%), in hip flexion (49.3%) and limping (37.5%). Ultrasound depicted medium joint effusion in 53.4%, marked effusion in 46.6% and synovial thickening in 17.1% of patients. 119 patients could be followed up weekly. Joint effusion vanished after 3-36 days (Ø 13.3 d), clinical symptoms Ø 1.6 days earlier. Total duration in terms of sonographic appearance of effusion was 3 to 37 days (Ø 19.1 d).
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