Diferencia entre revisiones de «Transient (toxic) synovitis»
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*Self-limiting inflammatory process of the hip | *Self-limiting inflammatory process of the hip | ||
*Most common cause of acute hip pain in children <10yr | *Most common cause of acute hip pain in children <10yr | ||
**Peak incidence 3- | **Peak incidence 3-8yrs, with a mean of 6 yrs | ||
*Male:Female is 2:1 | |||
*Usually unilateral | *Usually unilateral | ||
*70% present after recent viral URI | *70% present after recent viral URI | ||
Revisión del 17:08 29 dic 2014
Background
- Self-limiting inflammatory process of the hip
- Most common cause of acute hip pain in children <10yr
- Peak incidence 3-8yrs, with a mean of 6 yrs
- Male:Female is 2:1
- Usually unilateral
- 70% present after recent viral URI
- Possible posttraumatic or allerigc pathologies
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 >38.5
- ESR >40
- WBC > 12,000
- CRP>2
- Severe pain with ROM
- Septic arthritis favored by:
- Imaging
- Plain films or ultrasound can show effusion
- If effusion found consider arthrocentesis
- Presence of effusion does not rule in or out transient synovitis
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