Diagnosis: The correct diagnosis is transient synovitis. The child was discharged home on ibuprofen with planned follow-up the next day, and clear instructions to return if there was any worsening.
Transient synovitis is a self-limited disease with no expected long-term complications. It tends to occur in children between 2- and 9-years-old. Typically, the patient will complain of hip pain on one side and exhibit a limp. Thigh pain, knee pain, and low-grade fever (101 degrees F) may also be present.
Appropriate steps for the clinician to take upon presentation include WBC, ESR, x-ray and ultrasound. Treatment may include limiting the child\’s activity to make him or her more comfortable. However, there is no danger associated with performing normal activities. Nonsteroidal anti-inflammatory medications may be prescribed to reduce pain.
Case presented by Scott Field, MD, who treated and referred the patient described.
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