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Recurrences of transient synovitis of the hip
Insights
Transient synovitis of the hip can recur frequently in children, with over half of initial attacks leading to recurrence. Associated infections may play a role, but predicting recurrence is challenging due to non-specific symptoms.
Area of Science:
- Pediatric Orthopedics
- Rheumatology
- Infectious Diseases
Background:
- Transient synovitis of the hip is a common cause of hip pain in children.
- Recurrence is a known complication, but factors influencing it are not fully understood.
Purpose of the Study:
- To analyze recurrence patterns and identify potential predictors of recurrent transient synovitis of the hip in children.
Main Methods:
- Retrospective analysis of 126 episodes of transient synovitis in 36 children.
- Evaluation of clinical history, signs, and laboratory investigations (antistreptolysin O titre, throat swab cultures) for associated infections.
Main Results:
- Eighty recurrences were documented in 36 children; 18 children had no recurrences.
- No distinguishing features were found between initial attacks of children with and without recurrence.
- Evidence of associated infection was present in 72 episodes.
Conclusions:
- Predicting recurrence of transient synovitis of the hip is difficult due to non-specific clinical features and investigations.
- Recurrences can occur many years after the initial episode, even without preceding symptoms.
Abstract:
Thirty six children with transient synovitis of the hip had a total of 80 recurrences, 69 of them personally observed, and 11 described by the mother. No features distinguished the initial attack of those who had a recurrence from that of the 18 children who have not so far had a recurrence. We analysed the total of 126 episodes. In 72 there was evidence of an associated infection from the history, clinical signs, and a raised antistreptolysin O titre or isolation of a pathogen from a throat swab. The prognosis is difficult to assess because the symptoms, signs, and special investigations are not specific. Recurrences can occur after many years without symptoms.
