Recurrent transient synovitis of the hip in childhood. Longterm outcome among 39 patients.
OBJECTIVE
To describe the outcome of children with recurrent transient synovitis (TS) of the hip.


METHODS
A retrospective chart review of children with at least 2 separate episodes of TS between 1986 and 2003. We described the diagnostic investigations and outcome of these patients. A followup telephone survey for disability and pain scores was performed in 2004.


RESULTS
We studied 39 children, 26 boys and 13 girls, from 6 pediatric rheumatology centers. The mean age at initial episode was 6 +/- 2.6 years. There were a total of 102 episodes (mean 2.9 +/- 1.6, median 2, range 2-10). All but 2 children had normal plain radiographs of the hip. All patients were contacted 4.2 +/- 2.5 years after the first episode. None developed clinical Perthes disease or other chronic orthopedic condition. Three (8%) patients developed chronic disease: one had familial Mediterranean fever and 2 developed spondyloarthropathies, 0.5, 2, and 6 years after presentation. At followup 26 of 36 patients were asymptomatic, and 10 reported rare hip pain after intensive physical effort.


CONCLUSIONS
Children with recurrent TS usually have a benign course. In some patients recurrent TS may be the presenting feature of a chronic inflammatory condition. No progression to chronic orthopedic conditions was observed.
Department of Pediatrics, Pediatric Rheumatology, Meir Medical Center, Kfar Saba, Israel. uziely@zahav.net.il
Yosef
Y
Uziel
Yonatan
Y
Butbul-Aviel
Judith
J
Barash
Shai
S
Padeh
Masza
M
Mukamel
Natalia
N
Gorodnitski
Riva
R
Brik
Philip J
PJ
Hashkes
D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D013585:Synovitis / Q000000981:diagnostic imaging / Q000473:pathology*