Related Experiment Videos
Bilateral synovitis in symptomatic unilateral transient synovitis of the hip: an ultrasonographic study in 56
S Ehrendorfer1, G LeQuesne, M Penta
1Department of Orthopedic Surgery, Women's and Children's Hospital, Adelaide, South Australia.
Insights
Transient synovitis in children can affect the opposite hip, even without symptoms. Ultrasound measurements of the synovial capsular complex distance can reveal this asymptomatic synovitis, aiding diagnosis.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Rheumatology
Background:
- Transient synovitis is a common cause of hip pain in children.
- Diagnosis typically relies on clinical presentation and imaging of the symptomatic hip.
Purpose of the Study:
- To evaluate the contralateral hip in children diagnosed with unilateral transient synovitis.
- To assess the utility of synovial capsular complex distance measurement in identifying asymptomatic synovitis.
Main Methods:
- Bilateral sonographic assessment in 56 children with unilateral transient synovitis.
- Measurement of the synovial capsular complex distance (femoral neck to joint capsule).
- Comparison with age-dependent normal values and contralateral hip findings.
Main Results:
- All 56 symptomatic hips showed increased synovial capsular complex distance (mean 10 mm).
- 14 contralateral hips (25%) also had increased distance (mean 8 mm) and/or effusion.
- Findings suggest asymptomatic synovitis in a significant proportion of cases.
Conclusions:
- Transient synovitis may present asymptomatically in the contralateral hip.
- Measuring synovial capsular complex distance bilaterally is recommended for comprehensive assessment.
- Ultrasound can identify subclinical hip joint effusion and swelling.
Abstract:
56 children with a clinical diagnosis of unilateral transient synovitis of the hip underwent bilateral sonographic assessment. On the anterior scan, the distance between the femoral neck and the fibrous joint capsule was measured. This distance, which we call the synovial capsular complex distance, was compared with age-dependent normal values. An increased distance was found in all 56 symptomatic hips (mean 10 mm, SD 1.8). This distance was also increased in 14 hips on the contralateral side (mean 8 mm, SD 1.6). An effusion was demonstrated in 53 symptomatic hips and in 8 hips on the contralateral side. These findings indicate that in one quarter of children with symptoms of unilateral transient synovitis the contralateral hip may have an increased synovial capsular complex distance due to synovial swelling or joint effusion, suggesting an asymptomatic synovitis. We therefore recommend a comparison of the synovial capsular complex distance on the symptomatic side with age-related normal values, in addition to a comparison with the asymptomatic hip.