What Is Irritable Hip? What Is Acute Transient Synovitis? What Causes Irritable Hip?

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Main Category: Bones / Orthopaedics
Also Included In: Pediatrics / Children's Health;  Pain / Anesthetics
Article Date: 07 Oct 2009 - 9:00 PST

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The most common cause of hip pain in young children is the inflammation or swelling of the membrane covering the hip joint. It is known as irritable hip or acute transient synovitis.

According the Medilexicon's medical dictionary, synovitis is: "Inflammation of a synovial membrane, especially that of a joint; in general, when unqualified, the same as arthritis."

Usually, only one hip is affected. There is restricted movement in the hip joint. The pain can spread to the thigh, groin and knee areas, making standing and walking difficult. It often causes the child to limp.

This common childhood condition affects boys and girls of any age. However, it is most often seen in boys aged between two and twelve.

Although it is alarming for parents to see their child struggling to walk, the condition often promptly disappears and has no further complications. The specific cause of irritable hip is unclear, but it often follows either a viral infection or a physical injury.

After one to two weeks, it usually clears up without treatment. Complete rest during this period is typically all that is needed.

What are the symptoms of irritable hip?

Symptoms usually develop rapidly. A strong pain and restricted movement appear in one of the hip joints. In some cases, the pain can spread to the thigh, groin and knee.

Standing or walking may become very uncomfortable. As a result the child can develop a limp. Apart from this discomfort, the child is well.

The symptoms usually last for one to two weeks and then vanish quickly.

What are the causes of irritable hip?

Irritable hip is inflammation, pain and swelling of the synovial membrane that surrounds the hip joint. The synovial membrane is a layer of thin, fragile tissue that lubricates the joint and helps it to move.

The causes of this condition are unclear. However, in some cases the child will have had a viral infection in the previous days, such as a cold or sore throat. Sometimes, the condition occurs as a result of a fall or injury.

Irritable hip can also be a result of various types of childhood arthritis. In some cases a more serious condition, such as Perthes disease can be the cause. This is when the top of the thighbone softens and re-grows out of shape.

Diagnosis of irritable hip

Usually, an explanation of the symptoms during a medical visit will be sufficient for the diagnosis. The doctor will ask the child to try to move the affected leg.

In some cases there could be a referral to a hospital for additional tests in order to rule out more serious causes of the child's symptoms and to confirm the diagnosis of irritable hip. These can include:

• A blood test to detect traces of a bone or joint infection.


• An ultrasound scan to visualize the image of the affected hip joint and detect any fluid on the joint. If it is the case, it can be removed and tested for a more serious infection, called septic arthritis.


• An X-ray to check whether there is any problem with the child's bones.

What is the treatment for irritable hip?

• Painkillers, such as acetaminophen (paracetamol, Tylenol).


• Resting the hip joint through traction. Some children with irritable hip are treated in hospital where they may be put on traction for one or two nights. Traction involves applying a pulling force to the leg to keep it completely rested.


• If a hospital stay is not required, it is essential that the child completely rests at home. The most comfortable and painless position is lying on the back with the knee bent outwards slightly on the painful side. The foot should be pointed away from the body.


• Anti-inflammatory drugs (called NSAIDS) for children. It can help relieve pain and reduce inflammation.
  
  (Aspirin should not be given to children under 16. Ibuprofen should be avoided if your child has a history of asthma).

Recovery

Your child will usually fully recover within fourteen days. An additional hip X-ray will be needed about six weeks later to make sure the condition has cleared.

There are usually no complications and the condition hardly ever recurs.

The child should avoid playing sports or do any strenuous activity for at least two weeks after treatment. This is to reduce the chances of irritable hip returning.

Swimming is an excellent form of exercise. It gently helps to get the joint moving again.

Written by Stephanie Brunner M.A.
Copyright: Medical News Today
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