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Orthopaedics Pediatric orthopedics 67ef2976

Transient synovitis {toxic synovitis} of the hip is characterized by all of the following, except -

A
May follow upper respiratory infection
B
ESR and white blood cell counts are usually normal
C
Ultrasound of the joint reveals widening of the joint space
D
The hip is typically held in adduction and internal rotation
High-Yield Explanation
TRANSIENT SYNOVITIS : Definition: A self-limiting condition in which there is inflammation and swelling of the tissue around the hip joint. * Most common cause of acute hip pain in children 3-8 years old. * Boys affected twice > girls * The exact cause is unknown. Clinical Features Pain --groin region, front of thigh, sometimes up to knee Limping, crying Symptoms occur-- intermittently or after activity History of sore throat, cough, ear infection prior to limp pain O/E: * Slight wasting may appear * Restriction of all movements mostly at the extremes of the movement * Tenderness at the joint * Diagnosis of exclusion once trauma and infection are excluded. * Diagnosis is made primarily based on clinical features - Lab investigations are normal - X-ray show nothing more than slight widening of medial joint space . Management * Symptomatic * Bed Rest * Decrease activity of the joint * Traction -- might increase intra-aicular pressure * Joint Aspiration -- symptoms relieve but is sho-lived Mostly symptoms resolves within few days Weight bearing only after effusion disappears Good prognosis but repeated episodes may occur REF : MAHESWARI 9TH ED

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