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synonyms: transient synovitis, TS, toxic synovitis
Transient Synovitis ICD-10
- M67.90 - Unspecified disorder of synovium and tendon, unspecified site
- M67.911 - Unspecified disorder of synovium and tendon, right shoulder
- M67.912 - Unspecified disorder of synovium and tendon, left shoulder
- M67.919 - Unspecified disorder of synovium and tendon, unspecified shoulder
- M67.921 - Unspecified disorder of synovium and tendon, right upper arm
- M67.922 - Unspecified disorder of synovium and tendon, left upper arm
- M67.929 - Unspecified disorder of synovium and tendon, unspecified upper arm
- M67.931 - Unspecified disorder of synovium and tendon, right forearm
- M67.932 - Unspecified disorder of synovium and tendon, left forearm
- M67.939 - Unspecified disorder of synovium and tendon, unspecified forearm
- M67.941 - Unspecified disorder of synovium and tendon, right hand
- M67.942 - Unspecified disorder of synovium and tendon, left hand
- M67.949 - Unspecified disorder of synovium and tendon, unspecified hand
- M67.951 - Unspecified disorder of synovium and tendon, right thigh
- M67.952 - Unspecified disorder of synovium and tendon, left thigh
- M67.959 - Unspecified disorder of synovium and tendon, unspecified thigh
- M67.961 - Unspecified disorder of synovium and tendon, right lower leg
- M67.962 - Unspecified disorder of synovium and tendon, left lower leg
- M67.969 - Unspecified disorder of synovium and tendon, unspecified lower leg
- M67.971 - Unspecified disorder of synovium and tendon, right ankle and foot
- M67.972 - Unspecified disorder of synovium and tendon, left ankle and foot
- M67.979 - Unspecified disorder of synovium and tendon, unspecified ankle and foot
- M67.98 - Unspecified disorder of synovium and tendon, other site
- M67.99 - Unspecified disorder of synovium and tendon, multiple sites
Transient Synovitis ICD-9
- 727.9 Unspecified disorder of synovium, tendon and bursa
Transient Synovitis Etiology / Epidemiology / Natural History
- Most common cause of acute hip pain in children aged 3-10 years
- Nonspecific inflammation and hypertrophy of the synovial membrane identified in biopsy speicimens.
Transient Synovitis Anatomy
Transient Synovitis Clinical Evaluation
- Unilateral hip or groin pain. May report medial thigh or knee pain.
- Recent history of an upper respiratory tract infection, pharyngitis, bronchitis, or otitis media in 50% of patients
- Limp may be only initial complaint
- Generally afebrile or mildly elevated temperature; high fever is rare.
- Hip pain with passive ROM.
Transient Synovitis Xray / Diagnositc Tests
- A/P pelvis, A/P and frog lateral of the hip. May be normal or demonstrated soft tissue swelling / effusion / joint space widening.
- Ultrasonography guided aspiration: Indicated for temp >99.5°F, or ESR >20, of severe hip pain with ROM. Demonstrates an effusion that causes bulging of the anterior joint capsule.
- CBC and ESR may be slightly elevated. ESR >20 mm/h and/or temperature>37.5°C indicates septic hip.
Transient Synovitis Classification / Treatment
- NSAIDs, activity limitations, NWB while painful, consider bedrest.
- Hosptial admission indicated for observation in equivocal cases.
- Patients generally improve markdly in 24-28 hours. May have mild symptoms for several weeks.
Transient Synovitis Associated Injuries / Differential Diagnosis
- Septic Hip
- Perthes Disease / Avascular necrosis
- SCFE
- Fracture
- Gonococcal arthritis
- Lyme Diseasse
- Rheumatic arthralgias
- Tumor
Transient Synovitis Complications
- Coxa Magna
- Perthes Disease: @2%.
Transient Synovitis Follow-up Care
- Repear xrays in 6-12 months to eval for Perthes disease.
Transient Synovitis Review References
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