Transient Synovitis

Assume that any child with a fever who presents with refusal to walk has septic arthritis or osteomyelitis until proven otherwise. Transient synovitis is a diagnosis of exclusion - Cameron Gettel

Transient Synovitis
Transient Synovitis

image by: Lori Olsen Everson

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Acute limping in children

One of the most common reasons for acute limping is Transient Synovitis, also named ‘A-septic Arthritis’. This condition, representing a viral infection in a large joint, is most common between 3 and 10 years of age, with a mean age of 6 years. It occurs more frequently in boys and in vast majority of cases is unilateral (>90%).

Children are usually symptomatic for 24-48 hours before their parents seek advice from a health care provider. They may limp or not bear weight on the affected leg. They may have a low grade fever, albeit most patients are a-febrile. The hip is the most common joint involved in the process.

One of the key elements in illness history, that help with…

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 Acute limping in children

When children with a limp present to you, always consider the possibility of septic arthritis.

StatPearls

TS most commonly presents as acute unilateral limb disuse ranging from nonspecific hip pain or subtle limp to a refusal to bear weight. Depending on the age of the patient, the history may only be significant for the child or infant becoming increasingly agitated or crying more often than at baseline. Therefore, heightened clinical suspicion is warranted in younger pediatric patients and infants.

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