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Transient synovitis is a diagnosis of exclusion. [4] The diagnosis can be made in the typical setting of pain or limp in a young child who is not generally unwell and has no recent trauma. There is a limited range of motion of the hip joint. Nevertheless, children with transient synovitis of the hip can usually weight bear.
Other conditions under possible consideration are dermatomyositis, muscular dystrophy, juvenile idiopathic arthritis, transient synovitis of the hip, osteomyelitis, and myalgia. [1] Few muscle biopsies have been conducted. Results may show normal findings or features of inflammation and necrosis. [1]
The Kocher criteria are a tool useful in the differentiation of septic arthritis from transient synovitis in the child with a painful hip. [1] They are named for Mininder S. Kocher, an orthopaedic surgeon at Boston Children's Hospital and Professor of Orthopaedic Surgery at Harvard Medical School.
Synovitis causes joint tenderness or pain, swelling and hard lumps, called nodules. When associated with rheumatoid arthritis, swelling is a better indicator than tenderness. The joints in your hands and fingers feel painful when pressed and when moving or gripping anything.
Infectious tenosynovitis in 2.5% to 9.4% of all hand infections. Kanavel's cardinal signs are used to diagnose infectious tenosynovitis. They are: tenderness to touch along the flexor aspect of the finger, fusiform enlargement of the affected finger, the finger being held in slight flexion at rest, and severe pain with passive extension.
Remitting seronegative symmetrical synovitis with pitting edema (or sometimes RS 3 PE) is a rare syndrome identified by symmetric polyarthritis, synovitis, acute pitting edema (swelling) of the back of the hands and/or feet, and a negative serum rheumatoid factor. [2]
This category reflects the organization of International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Generally, diseases outlined within the ICD-10 codes M65-M68 within Chapter XIII: Diseases of the musculoskeletal system and connective tissue should be included in this category.
Acute exacerbation of juvenile idiopathic arthritis and transient synovitis of the hip both of which are non-septic conditions may mimic septic arthritis. More serious and life-threatening disorders as bone malignancies e.g. Ewing sarcoma and osteosarcoma may mimic septic arthritis associated with concurrent acute hematogenous osteomyelitis.