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Transient synovitis usually affects children between three and ten years old (but it has been reported in a 3-month-old infant and in some adults [3]). It is the most common cause of sudden hip pain and limp in young children. [4] [5] Boys are affected two to four times as often as girls. [5] [6] [7] The exact cause is unknown.
The condition is most commonly found in children between the ages of 4 and 10. Common symptoms include pain in the hip, knee, or ankle (since hip pathology can cause pain to be felt in a normal knee or ankle), or in the groin; this pain is exacerbated by hip or leg movement, especially internal hip rotation (with the knee flexed 90°, twisting the lower leg away from the center of the body).
A limp is a type of asymmetric abnormality of the gait.Limping may be caused by pain, weakness, neuromuscular imbalance, or a skeletal deformity. The most common underlying cause of a painful limp is physical trauma; however, in the absence of trauma, other serious causes, such as septic arthritis or slipped capital femoral epiphysis, may be present.
BACM symptoms that follow are most frequently calf pain, gait complaints, and inability to walk. [2] The condition is self-limited and full restitution can be expected. In very rare cases, however, rhabdomyolysis may develop. [1] Affected are preschool and school-age children with a male predominance. [2]
Joint pain is an important symptom, although some children experience minimal or no pain with their arthritis. [7] In these children, the first sign of arthritis may be limping, especially in the morning. [7] Young children are often very good at changing how they move when they have joint pain: they learn to move so that it does not hurt.
Claudication is a medical term usually referring to impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. [1] The perceived level of pain from claudication can be mild to extremely severe.
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The World Health Organization recommends using a two step treatment approach based on the level of pain in children. The first step explains mild pain treatment, while the second step considers moderate to severe pain. Opioids, such as morphine, is an example of a drug of choice for moderate-severe pain in children with medical illnesses. [36]