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Toxic Synovitis In Children: Causes, Symptoms and Treatment

What is Toxic Synovitis?

Toxic Synovitis is a medical condition seen mainly in children that causes pain and inflammation in the joints, almost always the hip joint. It is a temporary condition and is not a cause of worry even though the symptoms may come as a bit of surprise for both the parents as well as the caregivers. In most cases, the symptoms of Toxic Synovitis clear up in a matter of a few weeks but sometimes it may linger on for a month or so. There have not been any instances in the literature of any long term complications due to Toxic Synovitis.[1,2]

As stated, Toxic Synovitis usually affects children but there have been cases where adults have also been affected by it even though such cases are very rare and not well documented. Experts believe that it is more than likely that they might have developed septic arthritis which can be misinterpreted as Toxic Synovitis due to significant similarities in the symptoms.[1,2]

Septic Arthritis also causes hip pain as seen with Toxic Synovitis but septic arthritis is caused by a bacterial infection and can cause permanent damage if left untreated which is not the case with Toxic Synovitis.[1,2]

What Causes Toxic Synovitis?

Toxic Synovitis is a condition of which the root cause is still unknown. Various studies present in the literature have proposed various theories but nothing as of now has had substantial proof of being the cause of Toxic Synovitis. The However, there are certain risk factors that have been identified which puts a person at risk for this condition.[1]

According to experts almost all the patients with Toxic Synovitis have had a history of preceding upper respiratory tract infection. Thus it is the primary risk factor for Toxic Synovitis. Additionally, bacterial infections or any trauma have also been identified as risk factors for Toxic Synovitis.[1]

Experts have also observed that people with a known diagnosis of Toxic Synovitis are more than likely to have experienced vomiting, diarrhea, or common cold which are the primary symptoms of a viral infection. Another study stated that people with Toxic Synovitis have higher concentrations of serum interferon levels.[1]

What are the Symptoms of Toxic Synovitis?

The primary symptom of Toxic Synovitis in children include sudden onset of unilateral hip and leg pain. The pain may be so severe that the child will be reluctant to even walk. Due to the pain, even if the child walks he or she will be walking on tiptoes. Children below one year of age with Toxic Synovitis will cry incessantly due to pain in the hips. There may also be some low grade fever. Children about 5 years of age will complain of hip pain after sitting for some time.[2]

In majority of the cases of Toxic Synovitis, there will be a positive history of preceding viral infection. When talking about adults, as stated above Toxic Synovitis is quite rare but they can develop septic arthritis which has similar symptoms to that of Toxic Synovitis.[2]

The joints involved with septic arthritis are the elbows, knees, and hip. The individual will experience swelling with erythema of the affected joint. There will be severe pain with any movement. The mobility of the joint will also be severely restricted. The individual may also complain of fever and chills.[2]

How is Toxic Synovitis Treated?

Toxic Synovitis is a temporary condition and thus there is nothing much in the way of treatment for it. However, rest is the key for early resolution. While the symptoms of Toxic Synovitis are at its peak, the child should avoid any strenuous activity like running, sprinting or lifting. Antiinflammatory medications are the drugs of choice for treating Toxic Synovitis. These medications will calm down the pain and inflammation and promote normal ambulation without any discomfort.[2]

In majority of the cases, over the counter medications should be good enough to treat the symptoms of Toxic Synovitis. However, if the symptoms do not get better then a visit to physician is recommended for stronger pain medications. With regard to recovery, it normally takes around two weeks for the child to completely recover from Toxic Synovitis even though there have been cases documented where it has taken up to a month for the symptoms to resolve.[2]

Toxic Synovitis is a benign condition and there are no documented complications arising out of it. However, there have been cases of recurrence of this condition. Some experts have stated that the chances of recurrence of Toxic Synovitis in children are up to around 25%. With regard to the overall prognosis, a full recovery from Toxic Synovitis can be expected within 2 weeks.[2]

It is important to get a proper diagnosis from a physician and take medications as directed for speedy recovery and to rule out more serious underlying condition. This is highly recommended in children under the age of 3 years and above 10 years of age, has high fever, and appears sick. In adults, Toxic Synovitis is rare but septic arthritis is definitely a possibility which if not treated can cause permanent damage. Thus it is vital to get a diagnosis and start treatment both in adults and children if they show any signs which might indicate presence of Toxic Synovitis.[2]


Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 4, 2021

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