Transient synovitis of the hip joint in children.

A clinical review of 47 eases of transient synovitis of the hip joint occurring in patients less than 14 years of age is presented. Evidence from clinical, bacteriologic and serologic data is presented to show that in four patients acute streptococcal infection was associated with the development of transient synovitis. In one other patient clinical and serologic data disclosed a similar parallelism with an infection by the Coxsackie B virus. These findings suggest that these agents may be among those etiologically responsible for this syndrome. An obese or stocky physique probably predisposes a child to this disease. Patients with transient synovitis do not have any diagnostic abnormalities which can be detected by roentgenographic examination. Prevention of weight bearing by bed rest until the patient is completely asymptomatic provides the best form of therapy, and failure to follow such treatment results in prolongation of the illness. Antibiotics do not appear to influence the course of the disease. Three patients in this series developed Legg-Perthes disease within an interval of 3 to 17 months after convalescing from transient synovitis of the hip.