Summary about Disease
Irritable hip, also known as transient synovitis, is a common condition that causes hip pain and limping in children, typically between the ages of 3 and 10. It involves inflammation of the lining of the hip joint (the synovium). It's usually self-limiting and resolves on its own without long-term complications. However, it's crucial to rule out other, more serious conditions, such as septic arthritis or Legg-Calvé-Perthes disease.
Symptoms
Hip pain (may also be in the groin, thigh, or knee)
Limping or refusal to walk
Limited range of motion in the hip (especially internal rotation)
Low-grade fever (in some cases)
Crying or irritability, especially when moving the hip
Causes
The exact cause of irritable hip is often unknown (idiopathic). However, possible triggers include:
Viral infection (recent upper respiratory infection)
Trauma (minor injury to the hip)
Allergic reaction
Medicine Used
Pain relievers: Over-the-counter medications like ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) are commonly used to manage pain and inflammation.
Naproxen: Some doctors may prescribe this NSAID for pain and inflammation, but it's less frequently used than ibuprofen.
Is Communicable
No, irritable hip is not communicable. It is not caused by a contagious organism.
Precautions
Rest: Limit weight-bearing activity and encourage rest.
Avoid strenuous activity: Avoid activities that could further irritate the hip joint.
Follow doctor's instructions: Adhere to the prescribed medication regimen and follow-up appointments.
Hydration: Ensure the child stays hydrated
How long does an outbreak last?
The duration of irritable hip is typically self-limiting, lasting from a few days to about two weeks. Symptoms usually improve within 3-10 days with rest and pain management.
How is it diagnosed?
Physical Examination: A doctor will examine the child's hip, assess range of motion, and look for signs of pain or tenderness.
Medical History: The doctor will inquire about recent illnesses, injuries, and other relevant medical history.
Blood Tests: Blood tests (e.g., complete blood count [CBC], erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]) may be performed to rule out infection.
X-rays: X-rays of the hip are often taken to exclude other conditions, such as fractures or Legg-Calvé-Perthes disease.
Ultrasound: An ultrasound can help identify fluid in the hip joint, supporting the diagnosis of synovitis.
Timeline of Symptoms
Initial Phase: Sudden onset of hip pain, limping, or refusal to walk.
Acute Phase: Symptoms are most intense, with significant limitation of hip movement. This typically lasts for a few days.
Recovery Phase: Pain gradually decreases, and the child's range of motion improves.
Resolution: Symptoms resolve completely, and the child returns to normal activity. This usually happens within 1-2 weeks.
Important Considerations
Rule out other conditions: It's essential to differentiate irritable hip from more serious conditions, such as septic arthritis, osteomyelitis, or Legg-Calvé-Perthes disease.
Follow-up: Follow-up appointments with the doctor are important to monitor the child's progress and ensure the condition is resolving as expected.
Parental reassurance: Parents should be reassured that irritable hip is usually a self-limiting condition with a good prognosis.
Early intervention: Early diagnosis and management can help alleviate pain and prevent complications.