The Significance of Arthrocentesis on Transient Synovitis of the Hip in Children / 대한정형외과학회잡지

PURPOSE: To evaluate the significance of arthrocentesis on transient synovitis of hip in children with a moderate degree of limping and large joint effusion. MATERIALS AND METHODS: 119 cases of transient synovitis of the hip were evaluated retrospectively between January 1999 and December 2003, with respect to age (mean age: 5.6 years), sex (M: F=89: 30), location (Right: Left=68: 51), chief complaints (limping: 72; hip pain: 39; knee pain: 37), physical examination (limited internal rotation: 98), sonography of capsule neck distance (mean 5.9 mm), duration of hospitalization and morbidity. Among them, 47 cases with greater than 8 mm in capsule neck distance on sonography were compared, based on the duration of hospitalization, morbidity, and the change of capsule bulging between 18 cases in the arthrocentesis group and 29 cases in the non-arthrocentesis group. RESULTS: The mean duration of hospitalization and morbidity were 1.7 days, 4.7 days in the arthrocentesis group and 2.1 days, 6.6 days in the non-arthrocentesis group, the distance of the capsule bulging decreased from 9.2 mm to 4.5 mm in the arthrocentesis group and from 9.0 mm to 7.6 mm in the non-arthrocentesis group. The duration of hospitalization, morbidity, clinical course and decrease in capsule bulging were more effective, statistically in the arthrocentesis group than in the non-arthrocentesis group. CONCLUSION: Arthrocentesis for transient synovitis can be effective method of treatment in cases of moderate degrees of limping and large joint effusions, in spite of the disadvantage of the invasiveness of the procedure.

A study on relationship between juvenile transient synovitis and enterovirus / 临床外科杂志

Objective To study the relationship between juvenile transient synovitis of the hip and enterovirus.Methods EV-IgM antibody was detected with ELISA in blood and arthrocentesis. At same time, sample with coxsackievirus B(CVB) IgM positive was tested by serptype.Results IgM antibody was detected in 38.27% in blood of the patients and in 76.19% in arthrocentesis.CVB-IgM was found positive in 16.05% of blood and in 42.86% of arthrocentesis.AdV-IgM was in 11.73% and in 23.81%,respectively.Most of the CVB-IgM positive individuals were infected with CVB3.Conclusion The results of this study suggest that there may be a significant correlation between juvenile transient synovitis and CVB, especially CVB3.

Changes of Femoral Head Bone Density in Transient Synovitis of the Hip : using the pixel value in PACS (picture archiving & communication system) / 대한정형외과학회잡지

PURPOSE: Bone density changes of the femoral head in transient synovitis of the hip were investigated by analyzing the PACS pixel value. MATERIALS AND METHODS: Seventy seven patients diagnosed as unilateral transient synovitis of the hip were investigated. Conventional plain anteroposterior (AP) and frog-leg lateral projection films of the hip were studied for pixel value measurements in PACS. The pixel values of the center of femur head, the periphery of femur head, the femur neck, and the intertrochanter of proximal femur were measured. RESULTS: The pixel value ratios for healthy versus involved sites at the center of the femoral head, at periphery of the femur head and at the femur neck were 1:0.967, 1:0.967 and 1:0.967 on AP view, and 1:0.961, 1:0.955 and 1:0.965 on frog-leg lateral view. The relative pixelvalues were maximally decreased around 2 weeks after symptom onset. After 2 months pixel values of the involved side were nearly normal. CONCLUSION: There was a significant decrease in the pixel value of the involved side, which may have been due to disuse atrophy. Also, the pixel value seemed to be useful for quantifying changes of the bone density in transient synovitis of the hip.

Classification of Transient Synovitis with Magnetic Resonance Imaging / 대한정형외과학회잡지

PURPOSE: To classify the type of transient synovitis and determine a treatment plan using MRI. MATERIALS AND METHODS: From March 1985 to October 1998, 37 hips in 33 children with clinical symptoms of transient synovitis were evaluated with MRI. The average age of the patients was 7.5 years (range, 3.5-15 years) . The mean follow-up period was 18 months (range, 12-36 months) . The 37 hips were classified as grade l, ll, lll, or lV according to the amount of accumulated joint fluid on MRI. RESULTS: Of 37 hips with transient synovitis, 36 hips had no involvement of epiphysis and metaphysis and one hip had a cyst and bone marrow edema in the metaphysis on MRI scans. The amount of joint fluid was classified as seen on MRI scans: grade 1 in 2 hips, grade 2 in 14 hips, grade 3 in 5 hips, and grade 4 in 16 hips. CONCLUSION: MRI is a very useful diagnostic tool to classify and determine the treatment plan for transient synovitis. In patients with grade 3 and 4 joint fluid, the risk of vascular compromise of the femoral epiphysis could be higher. These patients should be hospitalized and immobilized in flexed position of the hip. Patients with grade 1 and 2 joint fluid can be treated at home with immobilization.

Clinical Epidemiologic Studies on Children with Transient Synovitis of Hip / 实用儿科临床杂志

Objective To investigate the clinical epidemiologic features of transient synovitis(TS) of hip in children occurred in Shen-zhen district.Methods The medical files were reviewed and a standard questionnaire was filled according to the conditions of 705 cases such as pathogeny,clinical manifestation,therapy and prognosis.Results Transient synovitis occurred in a sporadic form all the year round.The peak age of patients with TS was 3-7 years old.The ratio of boys to girls was 2.9:1.About 19.3% patients were attacked an upper respiratory tract infection and 11.9% patients attributed the symptoms to trauma or severe activities before 1 week.A varying degree of painful limp and restriction of movement at the hip were found clinically.All of cases were cured by skin traction.The incidence of recurrence was 6.95%.Conclusions Male predominance is found in TS.It is characteristic of sporadic form in the 4 seasons and intently relation to an upper respiratory tract infection and trauma or severe activities.TS is recurrent and the prognosis is good by skin traction.

A Clinical Significance of Ultrasonography in Transient Synovitis of the Hip / 대한정형외과학회잡지

Transient synovitis of the hip is non-specific inflammation and self limited condition, which is most common cause of painful limping in children under 10 years of age. Ultrasonography presents some merits, simple, rapid, non-invasive, low cost, repetitive to assess soft structures in and around the hip joint compared to other diagnostic methods. We prospectively studied 32 cases of unilateral transient synovitis at OPD from Jan. 1988 to Oct. 1989 using 5-7.5 MH, probe ultrasonography. 2-times serial check up in symptomatic and asymptomatic stage about capsule thickness and bone-capsule distance in 3 different positions of the both hips were performed for comparision. The following results were obtained; 1. Boys were 25 cases (78%) and 26 cases (83%) were between 3 and 7 years old of age. 2. Bone-capsule distance in ultrasonography revealed abnormal increase in 72%. 3. External rotation position showed wider bone-capsule distance than other position. 4. Capsule thickness was 3.3mm in diseased and 3.0mm in sound, 0.3mm decrease after treatment. 5. Bone-capsule distance was 4.5mm in symptomatic stage, 2.7mm in asymptomatic stage, 1.8mm decrease after treatment in averge.

Observance on the effectiveness of partial irradiation of TDP light on transient synovitis of the hip in children / 重庆医科大学学报

Objective:To discuss the way of speeding up the recovery of children with transient synovitis of the hip.Methods:The treatment effects of 100 cases of transient synovitis of the hip in children from January,2005 to April,2006 wene randomly analyzed.The patients wene randomized into treatment group and control group.The treatment group received the normal treatment added with partial irradiation of TDP light ,and the control group received only the normal treatment.Results:One weak after the treatment,the B-model ultrasound found that the variance of synovium thickness,the change value of articular cavity cleft width,amendment rate of cavity liquid and the negative rate of"4"words experiment of the treatment group were all better than those of the control group(P

The Clinical Study of Transient Synovitis of the Hip Joint in Children / 대한정형외과학회잡지

Transient synovitis of the hip joint in children was first described by Lovett and More in 1892and is the commonest cause of painful hip in children. It is characterized by pain and limp of acute onset, generally shart-lived, unassociated with structural changes in the femoral capital epiphysis demonstrable roentgenographically.. The pathology is of interest, not because it is a disabling condition, but because of the difficulties in differentiating it from more serious disease of the hip such as Legg-Calve-Perthes disease, tuberculosis, osteomyelitis and etc. The 76 cases so diagnosed at the Han-II hospital from 1974 to 1983 were reviewed and reported as follows; 1. There was probably associated with predisposing factors such as infection, and trauma. 2. The diagnostic criteria were clinical symptoms, laboratory and radiological findings. 3. The treatment was bed rest, skin traction on the affected leg, non-weight bearing, antibiotics, sedatives and in a few cases, INH was administrated for the prevention of the tuberculosis. 4. Four hips among them revealed later as Legg-Calve-Perthes disease and tuberculous arthritis of the hip joint.

Clinical Study of Transient Synovitis of the Hip / 대한정형외과학회잡지

Transient synovitis is characterized by the development of pain arising from the hip and often felt in the thigh or knee in children between the ages of 2 and 12 years. The benign self-limiting nature of this condition has made it difficult to establish the caus'e. However, the condition is generally conceded to be the commonest cause of a painful hip in childhood. The disease is of interest, not because of its disabling condition, but because of the difficulty in differentiating it from more serious diseases of the hip, such as tuberculosis, osteomyelistis, or Legg-Perthes disease. The author had studied the clinical symptoms and signs, roentgenologic findings, and treatment of the 34 patients who had admitted to Severance Hospital Yonsei Medical Center in Seoul, Korea from January 1970 to December 1979, under the diagnosis of the transient synovitis of the hip and summerized the results as follows; 1. There was probably associated with predisposing factors such as infection and allergy. 2. Among the 34 patients, 28 cases(82.4%) were male and 6 cases(17.6%) were female. The most prevalent age were between 6 and 10 years old. 3. Pain and limitation of motion of the hip joint were the most common symptoms. In 56.5% of the patients, roentgenographic findings were positive. In 50% of the patients, the erythrocyte sedimentation rates were increased. 4. The treatment was conservative including bed rest, skin traction on the affected leg, non-weight bearing, antibiotics, and sedatives. Most of all patients had improved symtoms and signs within two weeks of treatment. 5. The course of this condition was short and benign with complete resolution. The occasional hip with chronic or recurrent symptoms could be distinguished from Legg-Perthes disease by the short history, normal radiographs, and the complete resolution.

The Clinical Study of Transient Synovitis of the Hip Joint in Children / 대한정형외과학회잡지

One of a fairly common cause of painful hips in children is the transient synovitis which subcide in short time by bed rest. This transient synovitis is also called as observation hip, irritable hip, coxitis serosa seu simplex, transitory hip arthritis, transitory coxitis, acute transient epiphysitis, toxic synovitis, and intermittent hydrathrosis etc. It is not clear what is the exact cause of transient synovitis but many authors agree infection, trauma and allergic conditions can be cause of that disease. The disease is of interest, not because it is a disabling condition, but because of the difficulties encountered in differentiating it from more serious disease of the hip such as Legg-Calve-Perthes disease, tuberculosis, osteomyelitis and etc. Of the 67 cases so diagnosed at the catholic medical college from 1975 to, 1980, 30 were reviewed and reported. Following observation were made: 1. The main symptom was pain of sudden onset in the region of the hip joint with a limp on the: affected side. 2. The patients mean age was 7.4 yrs and the sex ratio of boy & girl revealed 1. 7:1. 3. Radiological abnormalities of the soft tissue shadow of the affected hip joint was noted at 24 cases (80%), among them the gluteal sign(50%) are more prominent than others Bone scanning with Tc was performed at 13 cases. Increased uptake density of radio-active isotopes found at 6 cases (46%). 4. The treatment was conservative including bed rest, skin traction on the affected leg, non weight bearing, antibiotics and anti-inflammatory drug. 5. Two hips among them revealed later as s Legg-Calve-Perthes disease and tuberculous arthritis of hip joint.