Transient Synovitis of the Hip in Children: Everything You Should Know
Dr. Teresa Rodríguez del Real
Transient synovitis of the hip (also called “irritable hip”) is a common cause of sudden limping in children aged approximately 3 to 8 years. Although it understandably causes concern for families, it is a benign, self-limiting condition that in most cases resolves within one to two weeks with rest and anti-inflammatory treatment.
What Is Transient Synovitis of the Hip?
Transient synovitis is a temporary inflammation of the synovial membrane, which lines the inside of the hip joint. This inflammation causes pain, limited mobility and limping, but it does not permanently damage the bone or surrounding tissues.
It is the main cause of hip pain in childhood and usually leaves no long-term effects. However, it is important for a doctor to evaluate the child to rule out more serious conditions such as septic arthritis, which requires urgent treatment.
Causes and Triggering Factors
Although the exact cause is unknown, it is believed that transient synovitis is related to an inflammatory response of the immune system following a viral infection or, in some cases, after a mild trauma.
The most frequent causes are:
Previous respiratory infections, such as a cold or pharyngitis.
Post-viral inflammatory response, where the body reacts excessively to a recent infection.
Mild trauma, such as a fall or bump affecting the joint.
It is important to emphasise that transient synovitis is not a contagious disease and is not transmitted between people.
Most Common Symptoms of Transient Synovitis
Transient synovitis can begin suddenly, often after your child has had a cold or sore throat. The most common symptoms are:
Limping or refusal to walk.
Pain in the groin, thigh or knee. (The pain may “travel” along the nerves — this is called referred pain.)
Decreased hip mobility, especially in internal rotation and also abduction.
Low-grade fever or no fever at all.
Generally good condition. The child is usually active and has appetite, without appearing ill.
Pain can be more noticeable in the morning or after prolonged periods of sitting.
Diagnosis: Why a medical evaluation is important
The diagnosis of transient synovitis of the hip is established primarily through clinical and exclusion criteria. This means there is no definitive laboratory or imaging test to confirm it; rather, the physician must rely on a detailed medical history, a thorough physical examination, and the exclusion of other, more serious conditions with similar symptoms.
The main diagnostic challenge is the need to rule out septic arthritis, which is considered a true medical emergency in children. Any delay in diagnosing and treating septic arthritis can quickly lead to destruction of the joint cartilage and permanent complications.
For this reason, a thorough physical examination becomes the most important part of the diagnostic process. The doctor will carefully assess your child’s gait, any pain when moving the hip (especially during internal rotation), and their overall condition (presence or absence of high fever, signs of illness, or changes in general well-being). These findings help determine whether additional tests are needed—such as blood tests, an ultrasound, or an X-ray—to distinguish transient synovitis from more serious conditions.
During the evaluation, the pediatric orthopedic specialist or pediatrician will typically review:
Physical examination: hip mobility, level of pain, temperature, and general appearance.
Hip ultrasound: to check for excess joint fluid.
Blood tests (in some cases): to rule out a bacterial infection.
X-ray or MRI: if the diagnosis is uncertain or if symptoms do not improve as expected.
If your child develops sudden hip pain or starts limping, you can request an at-home orthopedic assessment in Madrid. The specialist can examine your child at home, avoiding unnecessary travel and reducing discomfort and stress.
Treatment and Home Care for Transient Synovitis
The treatment for transient synovitis is conservative, and simple measures are usually enough:
Relative rest: your child should avoid intense activities, but may move around as long as it does not cause pain.
Anti-inflammatory medication (NSAIDs): ibuprofen is the most commonly used option to relieve pain and reduce inflammation.
Good hydration and adequate rest.
Medical follow-up: if the pain does not improve within a week, or if symptoms get worse, it is important to be re-evaluated.
In more intense or prolonged cases, a short period of hospital observation may be needed, especially if the child has fever or appears unwell.
When to See an Orthopedic Specialist
Although transient synovitis is a benign condition, there are situations that require immediate medical evaluation:
High fever or your child appearing unwell.
Severe pain that does not improve with anti-inflammatory medication.
Inability to bear weight or move the leg at all.
A limp that lasts more than 7–10 days.
Swelling, redness, or warmth around the hip.
These signs may indicate a more serious condition, such as septic arthritis or osteomyelitis (a bone infection), which must be treated as soon as possible.
Follow-up and Prognosis of Transient Synovitis
The outlook is generally excellent. In most cases, symptoms disappear completely within one to two weeks, leaving no long-term effects.
In some children—especially those with repeated viral infections—transient synovitis may come back, although this is uncommon.
Parents should continue observing their child over the following days and consult their doctor or a pediatric orthopedic specialist if they have any doubts or concerns.
Transient synovitis of the hip is a mild and temporary inflammation, very common in childhood, and it typically resolves with rest and anti-inflammatory medication.
Even though it usually follows a benign course, it is essential for a doctor to examine the child to rule out more serious causes of hip pain or limping.
If you need a fast evaluation without leaving home, you can request a home visit from an orthopedic specialist in Madrid, who can examine your child in the comfort and safety of your own home.
Frequently Asked Questions About Transient Synovitis
What is transient synovitis of the hip?
It is a temporary inflammation of the synovial membrane of the hip that causes pain and limping in children between 3 and 8 years old. It is a benign condition and usually resolves within 1–2 weeks with rest and anti-inflammatory medication.
What are the most common symptoms of transient synovitis?
Limping or refusal to walk, pain in the groin/thigh/knee (referred pain), reduced range of motion (especially internal rotation), low-grade fever or no fever, and generally good overall condition. Symptoms often appear more clearly in the morning.
What causes transient synovitis in children?
It often appears after a recent viral infection (such as a cold or sore throat) as a post-viral inflammatory response. It can also occur after a minor injury. It is not contagious.
How is transient synovitis diagnosed?
Diagnosis is clinical and based on exclusion. It includes a detailed medical history and physical examination, and, if needed, an ultrasound to look for fluid in the joint, blood tests, or an X-ray to rule out more serious conditions such as septic arthritis.
What is the treatment for transient synovitis?
Relative rest, anti-inflammatory medication (e.g., ibuprofen), good hydration, and follow-up. Most children recover within 1–2 weeks; if symptoms do not improve, the child should be reassessed.
When should you see a pediatric orthopedic specialist?
If the child has high fever or appears unwell, severe pain that does not improve with anti-inflammatory medication, complete inability to bear weight, limping lasting more than 7–10 days, or marked local signs of inflammation. These signs may indicate septic arthritis or another condition that requires urgent medical attention.
