ATS remains a diagnosis made after other entities are excluded. Several conditions have signs or symptoms that mimic all or part of the clinical presentation and course of ATS, including soft tissue injury and associated with play or sports, fracture, pyogenic arthritis, the initial synovitis of Perthes, childhood arthritis, osteomyelitis, tumor, or slipped capital femoral epiphysis. Gender and age as well as data from history taking, physical examination, and diagnostic studies should uncover these important causes of childhood hip pain. Two thirds to three fourths of children with ATS experience complete resolution of their pain within 2 weeks of the onset of symptoms. The remainder may have symptoms of lesser severity for several weeks.
Few children experience long-term functional sequelae.
When other conditions have been excluded, the fundamental treatment for ATS is rest and reduction of synovitis through the use of anti-inflammatory medication. At a minimum, rest means no weight-bearing during ambulation, and bedrest may be necessary to achieve pain relief. In bed, the leg should be allowed to go to a position of comfort, that is, flexion and external rotation. Traction is not a standard component of treatment. It does not relieve pain, perhaps because it is often applied with the hip in relative extension and neutral rotation.