Irritable Hip

What is an irritable hip?

Irritable hip (also called Transient Synovitis of the hip) involves inflammation of the lining (synovium) of the hip joint.

It is the most common cause of hip pain in children and a common cause of limping.

Children who have an irritable hip will usually be healthy and well with a sudden onset of pain and limping. Pain is usually felt in the groin and sometimes in the front of the thigh and knee. A child with an irritable hip may start limping or even refuse to put any weight through their leg. They may have a restriction of their hip movement, muscle spasms in their leg and a mild temperature.

There may be a recent history of a viral infection or a fall or injury.

Who gets it?

Irritable hip most often affects children aged from 3 to 10 years and can affect up to 3% of all 3-10 year old children. It affects boys more than girls (2:1).

The exact cause of an irritable hip is unknown, however, it may be related to an infection (such as an upper respiratory viral infection) or trauma.

What tests are required to diagnose an Irritable Hip?

An irritable hip will be diagnosed once other more serious conditions are excluded, your child will require an x-ray of their pelvis and hip. As well as a blood test to rule out an infection. An ultrasound may also be used to identify increased fluid within the joint. A careful clinical examination from your orthopaedic doctor is also required.

What is the treatment for an Irritable Hip?

The usual management involves resting the affected hip, usually by resting your child at home. Careful follow up examination with your orthopaedic doctor is important to ensure your child’s hip pain and hip movement improves. Usually this will take about one to two weeks. Your child should continue to rest at home until the hip symptoms have resolved.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can relieve pain and inflammation and can be useful to manage the symptoms of an irritable hip.

What is the natural history of an Irritable Hip?

For most children, an irritable hip is a short-term problem and your child is most likely to make a full recovery.

If a child does not have the opportunity to rest their hip for enough time it will often take longer to resolve. It may also make your child more at risk of having a recurrence of an irritable hip in the future. Up to 5-10 % of children who have an irritable hip with have a second episode