synovitis, toxic

Toxic synovitis, also termed transient synovitis, is an inflammation of the synovium (joint lining) of a single joint, usually the hip, often following a viral respiratory infection. It is assumed to be either caused by the virus itself, or more likely an immune reaction to the infection that cross-reacts with hip joint synovial tissue.

The condition most commonly affects boys from 3 to 10 years of age. The affected child may complain of pain in the hip, thigh, or knee. Blood tests (CBC, sedimentation rate) typically show no sign of infection or inflammation. X-rays and ultrasound tests may be used to show fluid accumulation in the joint; a needle tap of the joint is often done to rule out bacterial infection. Bone scan or x-rays may be done to rule out osteomyelitis, infection of bone.Aspirin (or now the more standard ibuprofen) and rest, sometimes with traction in the hospital, are the treatments used. Ibuprofen has been shown to shorten the course of the illness dramatically.1Recovery is complete and rapid.

1. Annals of Emergency Medicine 2002;40:294-299.

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