MR imaging of transient synovitis: differentiation from septic arthritis
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Transient synovitis is the most common cause of acute hip pain in children. However, MR imaging findings in transient synovitis and the role of MR imaging in differentiating transient synovitis from septic arthritis have not been fully reported.
To describe the MR findings of transient synovitis and to determine whether the MR characteristics can differentiate this disease entity from septic arthritis.
Materials and methods
Clinical findings and MR images of 49 patients with transient synovitis (male/female 36/13, mean age 6.1 years) and 18 patients with septic arthritis (male/female 10/8, mean age 4.9 years) were retrospectively reviewed.
MR findings of transient synovitis were symptomatic joint effusion, synovial enhancement, contralateral joint effusion, synovial thickening, and signal intensity (SI) alterations and enhancement in surrounding soft tissue. Among these, SI alterations and enhancement in bone marrow and soft tissue, contralateral joint effusion, and synovial thickening were statistically significant MR findings in differentiating transient synovitis from septic arthritis.
The statistically significant MR findings in transient synovitis are contralateral (asymptomatic) joint effusions and the absence of SI abnormalities of the bone marrow. It is less common to have SI alterations and contrast enhancement of the soft tissues. The statistically significant MR findings in septic arthritis are SI alterations of the bone marrow, and SI alterations and contrast enhancement of the soft tissue. Ipsilateral effusion and synovial thickening and enhancement are present in both diseases.
KeywordsTransient synovitis Septic arthritis Hip MR Child
We thank Bonnie Hami, Department of Radiology, University Hospitals Health System, Cleveland, OH, for editorial assistance in preparing the manuscript.
- 5.Marchal GJ, Van Holsbeeck MT, Raes M, et al (1897) Transient synovitis of the hip in children: role of US. Radiology 162:825–828Google Scholar
- 6.Mazur JM, Ross G, Cummings J, et al (1995) Usefulness of magnetic resonance imaging for the diagnosis of acute musculoskeletal infections in children. Pediatr Orthop 15:144–147Google Scholar
- 8.Lee JS, Na JB, Yoo JJ, et al (2000) MR findings of transient synovitis of the hip. J Korean Radiol Soc 42:353–358 (Korean)Google Scholar
- 10.Donaldson WF (1955) Transient synovitis of the hip joint. Pediatr Clin North Am 2:1073–1080Google Scholar
- 12.Finder JG (1936) Transitory synovitis of the hip joint in childhood. JAMA 107:3–5Google Scholar
- 13.Thulin WJ (1957) Transient synovitis of the hip joint in children. Rocky Mt Med J 54:238–241Google Scholar
- 14.Berger H (1939) Intermittent hydrarthrosis with an allergic basis. JAMA 112:2402–2405Google Scholar