Irritable Hip (Transient Synovitis)

This is a condition that can affect children of all ages but is more common in children from walking age to 5yrs.

The usual presenting problem is a child with a painful limp, but is otherwise systemically well. There is frequently a history of previous viral infection (chest, throat or ear) and this is the usual cause of the inflammation in the hip joint. The virus spreads to the hip and fluid collects here, causing some restriction in movement and difficulty weight-bearing.

This condition should always be taken seriously as it has to be differentiated from a condition known as Septic Arthritis of the hip which is caused by a bacterial infection. This latter condition is normally associated with a very unwell child who has other signs of sepsis such as fever, loss of appetite and severe pain on moving hip.

Any limping child with no significant history of injury should be assessed by the GP or A&E and referred on for investigation if required.

Irritable hip settles with rest and Calpol and should resolve fully within 1 week. It is not associated with any long term problems in the hip joint.