Childhood hip pain: Is it transient synovitis?

If your child suddenly develops hip pain or starts limping, and they were not injured, it could be a temporary condition called transient synovitis.

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If your child suddenly develops hip pain or starts limping, and they were not injured, it could be a temporary condition called transient synovitis.

Transient synovitis, also called toxic synovitis, is temporary inflammation of the hip that can cause limping and leg or hip pain in children.

“This condition often develops after having a viral infection, such as a cold or stomach virus, and the pain could be an immune system response as the body fights the infection.

“It usually goes away within a week and causes no long-term issues,” said Joshua W. Meier, M.D., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine.

Symptoms of transient synovitis

Childhood hip pain from transient synovitis often starts suddenly and is usually on one side of the body.

Other signs:

  • A recent viral infection, such as a cold or stomach virus
  • Low-grade fever
  • Limping with toes turned outward, the knee bent or straightened
  • Walking on tiptoes
  • Hip discomfort after a long period of resting the joint (such as sitting in a car or at a desk, or while watching TV)
  • Knee or thigh pain with no hip pain
  • Crying (in younger children)
  • Refusal to walk

In babies, the most common signs of toxic synovitis are abnormal crawling and crying. They may cry when their hip joints are being moved, such as during diaper changes, indicating hip pain.

Diagnosis and treatment

Your child’s pediatrician will conduct a physical exam to confirm that the limping is caused by joint pain. The provider may do blood tests or an ultrasound to detect fluid or swelling in the joints.

Sometimes transient synovitis can be confused with septic arthritis, which is a more serious condition caused by a bacterial infection in the joints. Diagnosing the condition may include testing fluid in the joint or X-rays.

If your child is diagnosed with transient synovitis, treatment usually includes anti-inflammatory drugs such as ibuprofen. Resting the hip joint is important until your child is comfortable again, which typically happens within a couple days after taking anti-inflammatory medication.