Toxic synovitis is a frequent cause of limping with hip pain in children. It occurs in children prior to the onset of puberty and is a transient arthritis of the hip that usually resolves on its own. Its cause in not known but boys are affected more frequently than girls (approximately 4 to 1).
Symptoms are usually mild and generally include hip pain and a slight limp. The hip pain almost always involves only one side (unilateral). A low grade fever (usually less than 101 degrees) may be an early symptom. Aside from the hip discomfort, the child does not usually appear ill.
Toxic synovitis is a diagnosis of exclusion, which means that it is diagnosed when other, more serious conditions, have been ruled out. In children there are three potentially serious diseases that can cause hip pain and limp: septic hip, slipped capital femoral epiphysis, and Legg-Calve-Perthes disease. Once these other diagnoses have been excluded, then the diagnosis of toxic synovitis (which is the most common of all these diseases) is usually made.
We were supposed to go to the Children’s Hospital today to see the rheumatologist about Shayel’s hip but the snow was so bad we had to cancel. I was reading copies of her labs while waiting for David and this is essentially what the doc. who reviewed her MRI thinks she has. The mystery is why her pain is lasting months and not not days. I guess that question will have to be posed to the doc. when we go to the rescheduled app. in February.