Transient Synovitis of the Hip: Identifying Characteristics, Underlying Causes, and Diagnostic Approaches
Irritable hip, also known as transient synovitis, is a common condition affecting children, characterised by hip pain and a limp. This article provides a comprehensive guide on managing irritable hip, focusing on non-medication approaches and other important considerations.
The onset of irritable hip is often preceded by an upper respiratory tract infection, cold, sore throat, or diarrhea, approximately two weeks prior [1]. In some cases, a fall or another injury could also be the cause. The pain associated with irritable hip can range from mild to severe, and it typically affects one side of the hip, though it may also impact the groin, thigh, and knee on the affected side [2].
Non-medication approaches emphasise staying active within comfort limits, strengthening and stretching muscles around the hip, using ice/heat therapy, managing stress, and modifying lifestyle factors to support recovery and symptom control [1][2][3][4].
Physical therapy and targeted exercises play a significant role in managing irritable hip. A physical therapist can tailor exercises to your needs, or you can do them at home. Activities like walking, gentle cycling, using an elliptical, and yoga (modified for comfort) are beneficial to maintain mobility and reduce stiffness [1][3].
The RICE method — Rest, Ice, Compression, and Elevation — helps reduce inflammation and promotes healing. Ice reduces inflammation, and resting avoids aggravating the hip [3]. Alternating ice (to reduce inflammation) and heat (to relax muscles and reduce tension) can provide symptom relief [1].
Avoiding aggravating activities helps prevent worsening pain. This includes avoiding deep stretching if it irritates tendons, and refraining from postures that increase hip discomfort [4]. Gentle massage of surrounding muscles like the gluteal muscles can ease symptoms, but avoid deep pressure on sensitive areas as that may worsen pain [4].
Stress and anxiety management techniques such as mindfulness, cognitive behavioral therapy, progressive muscle relaxation, and improving sleep hygiene can help manage the emotional aspects of chronic pain and potentially reduce symptom severity [2]. Maintaining a healthy diet and lifestyle, including weight management and a diet rich in anti-inflammatory foods, supports overall tendon and joint health [4][2].
In some cases, a doctor may order an imaging scan, such as an X-ray, or a blood test to detect infection. The doctor may recommend nonsteroidal anti-inflammatory drugs or acetaminophen for pain relief, but children under 16 years of age should not take aspirin [1].
Crutches or a pediatric walker to assist with walking should be used when necessary, and it may be most comfortable for the child to lie on their back, with their knee bent and turned out, and the foot on the affected side turned out [1].
It's important to note that a child with irritable hip usually does not need to spend time in the hospital. However, if there is a temperature of over 101°F or severe pain, another diagnosis needs to be considered, and the physician should be consulted [1].
Other conditions that cause symptoms similar to irritable hip include Perthes disease, fracture or contusion, a tumor in the hip, juvenile idiopathic arthritis, septic arthritis, and osteomyelitis. In acute transient synovitis, inflammation occurs in the synovial membrane that surrounds the hip [1].
The underlying reason for this inflammation is not clear, but possible explanations include a viral infection or an allergic reaction to an infection elsewhere in the body [1]. A diagnosis of irritable hip typically involves a physical examination by a primary care physician who will ask about symptoms [1].
Each of these conditions can cause a very sick child to develop elevated C-reactive protein levels and sedimentation rates [1]. If you suspect your child has irritable hip, it's crucial to consult a healthcare provider or physical therapist to ensure exercises and treatments are appropriate for your child's condition.
References: [1] NHS Choices. (2018). Irritable hip in children. Retrieved from https://www.nhs.uk/conditions/irritable-hip-in-children/ [2] Mayo Clinic. (2020). Transient synovitis. Retrieved from https://www.mayoclinic.org/diseases-conditions/transient-synovitis/symptoms-causes/syc-20355094 [3] KidsHealth. (2021). Irritable Hip. Retrieved from https://kidshealth.org/en/parents/irritable-hip.html [4] American Academy of Orthopaedic Surgeons. (2021). Irritable hip in children. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/irritable-hip-in-children/
- In some medical-conditions, such as irritable hip, the onset can be preceded by respiratory conditions like upper respiratory tract infections, colds, or sore throats.
- Science highlights that chronic diseases, including cance and autoimmune disorders, could potentially be worsened by stress and anxiety, necessitating mental-health therapies and treatments for proper management.
- Digestive-health is essential for overall wellness, and maintaining a healthy diet rich in anti-inflammatory foods can support tendon and joint health.
- Eye-health is often overlooked, but conditions like eye-strain and vision problems can develop from extended screen time, emphasizing the need for regular eye check-ups.
- Issues like hearing loss can impact neurological-disorders and cardiovascular-health,mathfrak{ equilibrium, making it crucial to address these conditions promptly through proper medical care.
- Skin-conditions, such as eczema or psoriasis, can be managed through various therapies-and-treatments, like topical creams, lighting therapy, or even lifestyle modifications.
- It's important to note that nonsteroidal anti-inflammatory drugs or acetaminophen, while often used for pain relief in medical-conditions, must be administered with caution, particularly in children under 16 years of age who should not take aspirin.
- A comprehensive approach to health-and-wellness should include addressing conditions like chronic diseases, respiratory-conditions, digestive-health, eye-health, hearing losses, neurological-disorders, cardiovascular-health, skin-conditions, and mental-health, working closely with healthcare providers for appropriate care and management.
