Transient (toxic) synovitis: Difference between revisions
(Created page with "==Background== Short-lived acute inflam of synovium of hip Usually unilateral Ages 2y-10y (peak 3-6) ==Diagnosis== Presentation - 70% present after recent viral URI -...") |
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==Background== | ==Background== | ||
Short-lived acute inflam of synovium of hip | Short-lived acute inflam of synovium of hip | ||
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Ages 2y-10y (peak 3-6) | Ages 2y-10y (peak 3-6) | ||
==Diagnosis== | ==Diagnosis== | ||
Presentation | Presentation | ||
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-Hip held in flex & adduction | -Hip held in flex & adduction | ||
Radiography: | Radiography: | ||
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*if any of following think septic hip: T >37.5, ESR >20. Pts w/ this had lower temp w/ avg wbc of 11.2 vs 13.2 if septic hip, but large degree of overlap! best test to differentiate is PE, w/ septic hip xtreme pain w/ minimal movt, TTS usu can tolerate ranging until xtreme movts! | *if any of following think septic hip: T >37.5, ESR >20. Pts w/ this had lower temp w/ avg wbc of 11.2 vs 13.2 if septic hip, but large degree of overlap! best test to differentiate is PE, w/ septic hip xtreme pain w/ minimal movt, TTS usu can tolerate ranging until xtreme movts! | ||
==Treatment== | ==Treatment== | ||
#Bed rest | |||
#NSAIDs | |||
==Prognosis== | ==Prognosis== | ||
#75% have resolution of sxs w/in 2 weeks; may last up to a month | |||
#Repeat XR in 6 mo to r/o L-C-P (2-6% will develop L-C-P) | |||
==See Also== | ==See Also== | ||
[[Hip Pain]] | |||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:Ortho]] | |||
Revision as of 04:48, 9 June 2011
Background
Short-lived acute inflam of synovium of hip
Usually unilateral
Ages 2y-10y (peak 3-6)
Diagnosis
Presentation
- 70% present after recent viral URI
- pts may have a low grade fever
-Pain at hip radiates to thigh & knee
-Hip held in flex & adduction
Radiography:
-AP pelvis may show effusion (joint widening)
-Ultrasound: effusion present in 95%
Labs:
-CBC and ESR/CRP nl to slightly elevated
- Dx of exclusion
- if any of following think septic hip: T >37.5, ESR >20. Pts w/ this had lower temp w/ avg wbc of 11.2 vs 13.2 if septic hip, but large degree of overlap! best test to differentiate is PE, w/ septic hip xtreme pain w/ minimal movt, TTS usu can tolerate ranging until xtreme movts!
Treatment
- Bed rest
- NSAIDs
Prognosis
- 75% have resolution of sxs w/in 2 weeks; may last up to a month
- Repeat XR in 6 mo to r/o L-C-P (2-6% will develop L-C-P)