What is the clinical course of transient synovitis in children: a systematic review of the literature

• Published in: Chiropractic & manual therapies Vol. 21; no. 1; p. 39
• Main Authors: Asche, Sylvana S, van Rijn, Rogier M, Bessems, Johannes Hjm, Krul, Marjolein, Bierma-Zeinstra, Sita Ma
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.11.2013; BioMed Central
• Subjects: Agreements; Bone surgery; Care and treatment; Children; Development and progression; Diagnosis; Disease; Diseases; Family medical history; Full text; Hypotheses; Prognosis; Studies; Synovitis; Systematic Review; Netherlands
• ISSN: 2045-709X; 2045-709X
• DOI: 10.1186/2045-709X-21-39

Transient synovitis of the hip (TS) is considered to be a self-limiting disease in childhood. However, because the etiology is unclear and some cases precede Legg-Perthes' disease, data on follow-up are important. Our aim was to summarize the knowledge on the clinical course of TS in children. The study design was a systematic review and a literature search was conducted in Medline and Embase. Studies describing short and/or long-term follow-up of TS in children were included. Case reports, reviews and studies describing traumatic hip pain were excluded. Study quality was scored and data extraction was performed. The main outcome measures were short-term and long-term clinical course, and recurrence of symptoms. A total of 25 studies were included of which 14 were of high quality. At two-week follow-up, almost all children with TS were symptom free. Those with symptoms persisting for over one month were more prone to develop other hip pathology, such as Legg-Perthes' disease. The recurrence rate of TS ranged from 0-26.3%. At long-term follow-up, 0-10% of the children diagnosed with TS developed Legg-Perthes' disease. Hip pain after intensive physical effort and limited range of motion of the hip at long-term follow-up was reported in 12-28% and in 0-18% of the children, respectively. The majority of the studies indicate that children with TS recover within two weeks; recurrence was seen in 0-26% of the cases. Children with TS should be followed at least six months to increase the likelihood of not missing Legg-Perthes' disease.