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    Toxic synovitis

    Synovitis - toxic; Transient synovitis

    Toxic synovitis is a condition affecting children that causes hip pain and limping.


    Toxic synovitis occurs in children before puberty begins. It is a type of arthritis of the hip. Its cause is not known, but boys are affected more often than girls (approximately 4 to 1).


    Symptoms may include:

    • Hip pain (on one side only)
    • Limp
    • Thigh pain, in front and toward the middle of the thigh
    • Knee pain
    • Low-grade fever, less than 101° Fahrenheit

    Aside from the hip discomfort, the child does not usually appear ill.

    Exams and Tests

    Toxic synovitis is diagnosed when other, more serious conditions have been ruled out, such as:

    • Septic hip
    • Slipped capital femoral epiphysis
    • Legg-Calve-Perthes disease

    Tests used to diagnose toxic synovitis include:

    • Ultrasound of the hip
    • X-ray of the hip
    • ESR
    • C-reactive protein (CRP)
    • Complete blood count (CBC)

    Other tests that may be done to rule out other causes of hip pain:

    • Aspiration of fluid from the hip joint
    • Bone scan
    • MRI


    Treatment often includes limiting activity to make the child more comfortable. However, there is no danger with performing normal activities. The health care provider may prescribe nonsteroidal anti-inflammatory medications (NSAIDS) to reduce pain.

    Outlook (Prognosis)

    The hip pain goes away within 7 - 10 days.

    Possible Complications

    Toxic synovitis goes away on its own. There are no expected long-term complications.

    When to Contact a Medical Professional

    Call for an appointment with your child's health care provider if:

    • Your child has unexplained hip pain or a limp, with or without a fever
    • Your child has been diagnosed with toxic synovitis and the hip pain lasts for longer than 10 days, the pain gets worse, or a high fever develops


    Sankar WN, Horn BD, Wells L, Dormans JP. Transient monoarticular synovitis (toxic synovitis). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 670.


          Self Care

            Tests for Toxic synovitis

              Review Date: 8/2/2011

              Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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              St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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