Transient synovitis of the hip

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer

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1st line – symptomatic relief

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1st line –

symptomatic relief

Treatment is focused on relieving symptoms and decreasing the synovial inflammation. Activity restrictions, and even a short period of bed rest, can be employed.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can be given for a short time with the appropriate precautions, such as discontinuation with any gastrointestinal symptoms. Ibuprofen has been shown to decrease the duration of symptoms.[19] Ketorolac may be considered in patients with severe pain or those unable to tolerate oral medications. While it is used clinically in children, it is not licensed for use in this patient group. Randomised placebo-controlled trials of ketorolac use in neonate, infant, and child populations are lacking, and data on efficacy and safety are low quality.[20][21]

Paracetamol may be used if the patient is unable to take NSAIDs.

Aspirin should be avoided due to concern regarding Reye's syndrome in paediatric patients.

Use the lowest effective dose for the shortest treatment duration.

Primary options

ibuprofen: children: 5-10 mg/kg orally every 6-8 hours when required, maximum 40 mg/kg/day

naproxen: children ≥2 years of age: 10-20 mg/kg/day orally given in 2-3 divided doses when required

paracetamol: children 3 months-1 year of age: 60-120 mg orally every 4-6 hours when required; children 1-6 years of age: 120-250 mg orally every 4-6 hours when required; children 6-12 years: 250-500 mg orally every 4-6 hours when required, maximum 4 doses/24 hours

Secondary options

ketorolac: children ≥6 months of age: consult specialist for guidance on dose

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