Physical and laboratory signs of sepsis should prompt quick referral for immediate aspiration of the joint under appropriate conditions. Transient synovitis is the most common cause of hip pain in children under age 10. Patients present with pain in the anteromedial aspect of the thigh and knee and walk with a limp. Motion is limited, and a flexion contracture of the hip may be present. Hematologic tests are negative with no signs of sepsis.
Transient synovitis is a self-limited benign condition.
Weight-bearing is limited, and radiographs are repeated in 2 to 3 months to rule out LCP disease, which may develop after an episode of transient synovitis. The hip is the third most common joint to be involved in pauciarticular juvenile rheumatoid arthritis. Children with pauciarticular juvenile rheumatoid arthritis do not present with systemic systems. The insidious onset is accompanied by swelling, stiffness, and minimal pain on motion. Effusion is palpable, and soft-tissue and bony changes are seen on radiographs.