Transient (toxic) synovitis: Difference between revisions
(→DDX) |
No edit summary |
||
| Line 6: | Line 6: | ||
*70% present after recent viral URI | *70% present after recent viral URI | ||
== | == Clinical Features== | ||
*Abrupt onset of unilateral hip pain, limp, and restricted hip motion | *Abrupt onset of unilateral hip pain, limp, and restricted hip motion | ||
*Nontoxic appearance | *Nontoxic appearance | ||
*May have a low grade fever | *May have a low grade fever | ||
== | ==Diagnosis== | ||
* | *Must distinguish from septic arthritis | ||
* | **Septic arthritis favored by: | ||
***Temp >37.5 | |||
***ESR >20 | |||
***Severe pain with ROM | |||
*Imaging | |||
**pain films or ultrasound can show effusion | |||
==DDX== | ==DDX== | ||
Revision as of 18:13, 12 April 2012
Background
- Self-limiting inflammatory process of the hip
- Most common cause of acute hip pain in children <10yr
- Peak incidence 3-6yr
- Usually unilateral
- 70% present after recent viral URI
Clinical Features
- Abrupt onset of unilateral hip pain, limp, and restricted hip motion
- Nontoxic appearance
- May have a low grade fever
Diagnosis
- Must distinguish from septic arthritis
- Septic arthritis favored by:
- Temp >37.5
- ESR >20
- Severe pain with ROM
- Septic arthritis favored by:
- Imaging
- pain films or ultrasound can show effusion
DDX
Treatment
- Non-weightbearing until pain resolves (usually 3-7d)
- Limited activity for 1-2wk
- NSAIDs
Disposition
- If dx is certain, PMD f/u within 2wk
See Also
Source
Tintinalli