ICD-10: M67.35

Transient synovitis of the hip, classified under ICD-10 code M67.35, is a condition characterized by inflammation of the synovial membrane in the hip joint. This condition is particularly common in children and can lead to hip pain and limping. Below is a detailed overview of transient synovitis, including its clinical description, symptoms, diagnosis, and management.

Clinical Description

Definition

Transient synovitis is an acute, self-limiting inflammatory condition of the hip joint, often seen in children aged 3 to 10 years. It is characterized by the presence of synovial fluid accumulation in the hip joint, which can lead to pain and restricted movement. The exact cause of transient synovitis is often unclear, but it may follow a viral infection or be associated with trauma.

Etiology

While the precise etiology remains uncertain, transient synovitis is frequently linked to:
- Viral infections: Recent upper respiratory infections are commonly reported prior to the onset of symptoms.
- Trauma: Minor injuries to the hip may precipitate the condition.
- Other inflammatory conditions: Conditions such as juvenile idiopathic arthritis may also be associated.

Symptoms

Patients with transient synovitis typically present with:
- Hip pain: Often localized to the groin or thigh, which may worsen with movement.
- Limping: A noticeable limp is common due to pain and discomfort.
- Limited range of motion: The affected hip may exhibit reduced mobility, particularly in internal rotation and abduction.
- Fever: Some patients may present with low-grade fever, although this is not always the case.

Diagnosis

Clinical Evaluation

Diagnosis of transient synovitis primarily involves:
- History and Physical Examination: A thorough history, including recent infections or trauma, and a physical examination to assess pain and range of motion.
- Imaging Studies:
- Ultrasound: Point-of-care hip ultrasound can be particularly useful in identifying effusion in the hip joint, leading to expedited diagnosis and management[7][8].
- X-rays: These may be performed to rule out other conditions, such as fractures or osteomyelitis.

Differential Diagnosis

It is crucial to differentiate transient synovitis from other conditions that may present similarly, such as:
- Septic arthritis: A more serious condition requiring immediate intervention.
- Perthes disease: Avascular necrosis of the femoral head.
- Osteomyelitis: Infection of the bone.

Management

Treatment Approaches

Management of transient synovitis is generally conservative and may include:
- Rest: Limiting weight-bearing activities to reduce stress on the hip joint.
- Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to alleviate pain and inflammation.
- Physical Therapy: Once symptoms improve, physical therapy may be recommended to restore strength and range of motion.

Prognosis

The prognosis for transient synovitis is generally favorable, with most children recovering fully within a few weeks. However, close monitoring is essential to ensure that symptoms do not worsen, which could indicate a more serious underlying condition.

Conclusion

Transient synovitis of the hip (ICD-10 code M67.35) is a common inflammatory condition in children that typically resolves with conservative management. Early diagnosis and appropriate treatment are crucial to prevent complications and ensure a swift recovery. If symptoms persist or worsen, further evaluation may be necessary to rule out more serious conditions.

Transient synovitis of the hip, classified under ICD-10 code M67.35, is a common condition primarily affecting children, characterized by inflammation of the synovial membrane in the hip joint. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for accurate diagnosis and management.

Clinical Presentation

Age Group

Transient synovitis typically occurs in children aged 3 to 10 years, with a higher incidence in boys than girls. The condition often presents after a viral infection or minor trauma, although the exact cause remains unclear[1].

Symptoms

Patients with transient synovitis usually exhibit the following symptoms:

• Hip Pain: The most prominent symptom is hip pain, which may be localized or referred to the knee. The pain can be acute and is often exacerbated by movement.
• Limping: Children may present with a noticeable limp due to pain and discomfort in the affected hip.
• Limited Range of Motion: There may be a reduction in the range of motion in the hip joint, particularly in internal rotation and abduction.
• Fever: Some patients may experience a low-grade fever, although this is not always present[2].

Signs

Upon physical examination, healthcare providers may observe:

• Tenderness: Palpation of the hip joint may elicit tenderness.
• Swelling: There may be mild swelling around the hip area, although significant swelling is less common.
• Decreased Mobility: The child may resist movement of the hip joint due to pain, leading to a protective posture[3].

Patient Characteristics

Demographics

• Age: Most commonly affects children between 3 and 10 years old.
• Gender: More prevalent in males, with a male-to-female ratio of approximately 3:1[4].

Medical History

• Recent Illness: Many cases are preceded by a viral upper respiratory infection or other minor illnesses, suggesting a possible infectious or inflammatory trigger.
• Trauma: While transient synovitis can occur without a clear history of trauma, some patients may report a recent minor injury to the hip area[5].

Risk Factors

• Family History: A family history of hip disorders or transient synovitis may increase the likelihood of occurrence.
• Environmental Factors: Participation in sports or activities that involve repetitive hip movements may also be a contributing factor[6].

Conclusion

Transient synovitis of the hip (ICD-10 code M67.35) is a self-limiting condition that requires careful evaluation to differentiate it from more serious conditions such as septic arthritis or osteomyelitis. Recognizing the typical clinical presentation, including age, symptoms, and signs, is essential for timely diagnosis and management. If transient synovitis is suspected, further imaging studies, such as ultrasound or MRI, may be warranted to confirm the diagnosis and rule out other pathologies. Early intervention and supportive care can lead to a favorable outcome, with most children recovering fully within a few weeks[7].

For any concerns regarding hip pain in children, it is advisable to consult a healthcare professional for a thorough assessment and appropriate management.

When discussing the ICD-10 code M67.35, which refers to Transient synovitis of the hip, it is helpful to understand the alternative names and related terms that may be used in clinical settings. This can aid in accurate diagnosis, coding, and communication among healthcare professionals.

Alternative Names for Transient Synovitis of the Hip

1. Transient Synovitis: This is the most straightforward alternative name, often used without specifying the hip joint.
2. Toxic Synovitis: This term may be used interchangeably in some contexts, particularly when the condition is thought to be related to an infectious or inflammatory process.
3. Iliopsoas Bursitis: While not identical, this term can sometimes be associated with transient synovitis, especially when inflammation occurs in the surrounding structures.
4. Hip Synovitis: A broader term that encompasses inflammation of the synovial membrane in the hip joint, which includes transient synovitis.

Related Terms and Conditions

1. Synovitis: A general term for inflammation of the synovial membrane, which can occur in various joints, including the hip.
2. Septic Arthritis: Although distinct, this condition can present similarly to transient synovitis and may require differential diagnosis.
3. Perthes Disease: A condition that affects the hip joint in children and can sometimes be confused with transient synovitis due to overlapping symptoms.
4. Osteoarthritis: While primarily a degenerative joint disease, it can also lead to synovitis and may be considered in differential diagnoses.
5. Rheumatoid Arthritis: An autoimmune condition that can cause synovitis in various joints, including the hip.

Clinical Context

Transient synovitis is most commonly seen in children and is characterized by hip pain and limping, often following a viral infection. It is essential for healthcare providers to differentiate it from more serious conditions like septic arthritis, which requires immediate intervention. The use of alternative names and related terms can facilitate better understanding and communication in clinical practice.

In summary, understanding the alternative names and related terms for ICD-10 code M67.35 can enhance clarity in diagnosis and treatment discussions, ensuring that healthcare professionals are aligned in their approach to managing transient synovitis of the hip.

Transient synovitis of the hip, classified under ICD-10 code M67.35, is a condition characterized by inflammation of the synovial membrane in the hip joint, often leading to pain and limited mobility. The diagnosis of transient synovitis involves several clinical criteria and diagnostic approaches to ensure accurate identification and differentiation from other conditions, such as septic arthritis or osteomyelitis.

Clinical Criteria for Diagnosis

1. Patient History

• Age: Transient synovitis commonly occurs in children, particularly those aged 3 to 10 years.
• Symptoms: Patients typically present with hip pain, limping, and reduced range of motion. Symptoms may follow a viral infection or occur without a clear preceding illness.

2. Physical Examination

• Joint Examination: The hip joint may exhibit tenderness, swelling, and decreased range of motion. The patient may prefer to keep the hip in a flexed and externally rotated position.
• Gait Assessment: Observing the patient's gait can reveal limping or favoring of the affected leg.

3. Imaging Studies

• Ultrasound: Point-of-care hip ultrasound is increasingly used to assess for effusion in the hip joint, which can indicate synovitis. This imaging modality allows for rapid diagnosis and can help differentiate transient synovitis from septic arthritis[5].
• X-rays: While X-rays may not show changes in transient synovitis, they are useful to rule out other conditions, such as fractures or osteomyelitis.

4. Laboratory Tests

• Blood Tests: Routine blood tests may include a complete blood count (CBC) to check for signs of infection (elevated white blood cell count) and inflammatory markers (such as C-reactive protein).
• Joint Aspiration: In some cases, aspiration of the hip joint may be performed to analyze synovial fluid. The fluid in transient synovitis typically appears clear or slightly cloudy, with a low white blood cell count, distinguishing it from septic arthritis, which usually presents with a high white blood cell count and purulent fluid.

5. Exclusion of Other Conditions

• It is crucial to rule out other potential causes of hip pain, such as septic arthritis, osteomyelitis, or trauma. This may involve a combination of clinical judgment, imaging, and laboratory results.

Conclusion

The diagnosis of transient synovitis of the hip (ICD-10 code M67.35) relies on a comprehensive assessment that includes patient history, physical examination, imaging studies, and laboratory tests. By carefully evaluating these criteria, healthcare providers can effectively diagnose transient synovitis and initiate appropriate management to alleviate symptoms and prevent complications. If you have further questions or need more specific information, feel free to ask!

Transient synovitis of the hip, classified under ICD-10 code M67.35, is a common condition primarily affecting children, characterized by inflammation of the synovial membrane in the hip joint. This condition often presents with hip pain, limping, and reduced range of motion. Understanding the standard treatment approaches for transient synovitis is crucial for effective management and recovery.

Overview of Transient Synovitis

Transient synovitis is typically self-limiting, meaning it often resolves on its own without extensive medical intervention. However, appropriate treatment is essential to alleviate symptoms and prevent complications. The condition is often associated with viral infections or may follow a minor trauma, and it is important to differentiate it from more serious conditions such as septic arthritis.

Standard Treatment Approaches

1. Rest and Activity Modification

One of the primary treatment strategies for transient synovitis is to ensure adequate rest for the affected hip. This may involve:

• Limiting Weight-Bearing Activities: Children are often advised to avoid running, jumping, or other high-impact activities that could exacerbate pain or inflammation.
• Use of Crutches: In some cases, crutches may be recommended to reduce weight on the affected leg while allowing for mobility.

2. Pain Management

Pain relief is a critical component of managing transient synovitis. Common approaches include:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as ibuprofen or naproxen can help reduce pain and inflammation. Dosage should be adjusted based on the child's age and weight.
• Acetaminophen: This can be used as an alternative for pain relief, especially in cases where NSAIDs are contraindicated.

3. Physical Therapy

Once the acute pain subsides, physical therapy may be beneficial to restore range of motion and strengthen the hip joint. This can include:

• Gentle Range of Motion Exercises: To prevent stiffness and improve mobility.
• Strengthening Exercises: To support the hip and prevent future episodes.

4. Monitoring and Follow-Up

Regular follow-up appointments are essential to monitor the child's progress. Physicians may recommend:

• Ultrasound or MRI: In cases where the diagnosis is uncertain or if symptoms persist, imaging studies may be used to rule out other conditions such as septic arthritis.
• Observation: Most cases resolve within a few weeks, but ongoing assessment ensures that any complications are addressed promptly.

5. Surgical Intervention (Rare)

In rare cases where there is significant joint effusion or if the condition does not improve with conservative management, surgical intervention may be considered. This could involve:

• Arthrocentesis: A procedure to drain excess fluid from the hip joint, which can relieve pressure and pain.
• Surgical Exploration: If there is suspicion of septic arthritis or other complications, a more invasive approach may be necessary.

Conclusion

The management of transient synovitis of the hip (ICD-10 code M67.35) primarily focuses on conservative treatment strategies, including rest, pain management, and physical therapy. Most children recover fully with appropriate care, and ongoing monitoring is essential to ensure a complete resolution of symptoms. If symptoms persist or worsen, further evaluation may be warranted to rule out more serious conditions.