title: Anterior joint capsule of the normal hip and in children with transient synovitis: US study with anatomic and histologic correlation.
abstract: OBJECTIVE
  To study the anatomic components of the anterior joint capsule of the normal hip and in children with transient synovitis.
  
  
  METHODS
  Six cadaveric specimens were imaged with ultrasonography (US) with special attention to the anterior joint capsule. Subsequently, two specimens were analyzed histologically. These anatomic findings were correlated with the US findings in 58 healthy children and 105 children with unilateral transient synovitis.
  
  
  RESULTS
  The anterior joint capsule comprises an anterior and posterior layer, mainly composed of fibrous tissue, lined by only a minute synovial membrane. Both fibrous layers were identified separately at US in 98 of 116 (84%) hips of healthy subjects and in all hips with transient synovitis. Overall, the anterior layer was thicker than the posterior layer. In transient synovitis compared with normal hips, no significant thickening of both layers was present (P = .24 and .57 for the anterior and posterior layers, respectively). Normal variants include plicae, local thickening of the capsule, and pseudodiverticula.
  
  
  CONCLUSIONS
  Increased thickness of the anterior joint capsule in transient synovitis is caused entirely by effusion. There is no US evidence for additional capsule swelling or synovial hypertrophy.
authors: Department of Pediatric Radiology, Sophia Children's Hospital, Rotterdam, The Netherlands.
authors: S G
authors: SG
authors: Robben
authors: M H
authors: MH
authors: Lequin
authors: A F
authors: AF
authors: Diepstraten
authors: J C
authors: JC
authors: den Hollander
authors: C A
authors: CA
authors: Entius
authors: M
authors: M
authors: Meradji
mesh_terms: D000328:Adult; D002102:Cadaver; D002648:Child; D005260:Female; D006621:Hip Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D006801:Humans; D017746:Joint Capsule / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D008297:Male; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography