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Paediatrics
intermediate
X-Type

Transient Synovitis

Irritable Hip

A 4-year-old boy presents with a 2-day history of right hip pain and limp. He had an upper respiratory tract infection 1 week ago. He is afebrile with temperature 37.2°C. He lies with the hip in slight flexion and external rotation. WCC is 8.2 × 10⁹/L, ESR is 12 mm/hr, and CRP is 5 mg/L. He is reluctant to weight-bear but can be coaxed to walk with a limp. Regarding the assessment of the irritable hip:

Mark each as TRUE or FALSE

A

The Kocher criteria for differentiating septic arthritis from transient synovitis include: (1) fever...

B

Transient synovitis is the most common cause of atraumatic hip pain in children aged 3-10 years; it ...

C

In transient synovitis the child is always febrile with temperature above 39°C; inflammatory markers...

D

Ultrasound is the investigation of choice to detect hip effusion; an effusion greater than 2mm compa...

E

Treatment of transient synovitis is supportive with rest, analgesia (NSAIDs), and activity modificat...

Answer the questions to see explanations

Click T (True) or F (False) for each option