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Orthopedics
miscellaneous
transient synovitis of hip
A 6-year-old girl is brought to the pediatric outpatient clinic by her parents due to a several-day history of right hip discomfort. Her parents report that she recently had a mild upper respiratory infection last week. She is able to ambulate but walks with a noticeable limp and avoids full weight-bearing on the affected side. She has no history of trauma or any other significant medical conditions. On examination, her temperature is 37.2°C, blood pressure is 105/65 mm Hg, pulse is 95/min, and respiratory rate is 18/min. Physical examination of the right hip reveals mild tenderness to palpation, no obvious erythema or significant warmth, but pain is elicited with passive internal rotation and abduction. An initial radiograph of the hip and pelvis is interpreted as normal. Which of the following is the most likely diagnosis and appropriate initial management for this patient?
| Lab Parameter | Value | Reference Range |
|---|---|---|
| C-reactive protein | 0.8 mg/L | <1.0 mg/L |
| White Blood Cell count | 8.5 x 10^9/L | 4.0-11.0 x 10^9/L |
| Erythrocyte Sedimentation Rate | 15 mm/hr | <20 mm/hr |
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