Introduction to transient synovitis of the pediatric hip joint

  The synovial membrane is a very thin layer of tissue on the inside of the joint capsule. Under normal circumstances, the synovial membrane secretes a small amount of fluid, the main purpose of which is to make the joint surface smoother when it is worn, much like adding lubricant to a machine. When there is an irritant inside the joint, whether bacterial, physical or chemical, the synovial membrane reacts first, causing congestion and edema, and exuding fluid, which swells the joint capsule and causes the joint to swell.  Over time, this becomes chronic synovitis. The frequency of pumping injections should be reduced as much as possible. Excessive pumping injections will stimulate the growth of fibers in the subsynovial connective tissue group and aging of synovial tissue, which will significantly reduce the ability of synovial tissue to regenerate and repair, making treatment more troublesome.  The bursa is a reservoir of oil, which is used to fuel the movement of the skeletal tendons, the purpose is to increase lubrication and reduce friction, if there is water, the water diluted the synovial fluid will not play a lubricating role, then the strenuous activity will produce skeletal friction and eventually damage the bones. The principle of treatment is to regulate and unblock the obstructed microcirculation, as long as the obstructed microcirculation is unblocked, the bursa secretion synovial fluid output and absorption to achieve a balance can be recovered.  There are many causes, one of the more common causes is the complications caused by viral infections (such as viral flu). Viral infections in the body result in varying degrees of immune response, which varies from person to person. Increased congestion and edema of the synovial membrane is one of the manifestations and is self-limiting. Most cases heal in 1 to 2 weeks.  Sometimes parents may find that their child suddenly walks with a limp, asks about the phenomenon of leg numbness, and has symptoms of leg weakness and fever when they are sick, but when they go to the hospital for an X-ray, the film suggests normal. If diagnosed by a doctor it will be found to be synovitis of the hip joint. It is often overlooked by parents because the symptoms are not very obvious.  Most of them occur in children aged 3 to 10 years old, because the development of the femoral head is still immature and the joint capsule is loose. Once the lower limb is excessively abducted, or jumped from a high place downward, or the lower limb is sprained due to unstable walking, or the joint capsule is stretched due to excessive running and jumping, or the joint capsule is squeezed and causes hip synovitis.  If the injury is acute, hip pain occurs immediately after the injury, and sometimes there is a slight swelling of the soft tissues on the front side of the hip joint and difficulty in walking, but some children just feel discomfort in the affected limb and walk with a limp after the injury, and the pain in the affected limb gradually increases after 2-3 days, and the limp becomes more and more serious when walking. The pain increases with activity, and because of the pain, the child’s pelvis often tilts to the affected side, so if you compare the lower extremities, you will find that the affected lower extremity is slightly longer.  A small number of children have a combination of low fever. Most of the pressure points are in the groin of the affected hip joint, or in the posterior pear-shaped muscle. The majority of pressure points are at the groin of the affected hip, or at the posterior pear muscle.  As parents of children, they should pay attention to the amount of activity of their children and avoid overexertion and damage to the joint capsule due to the large amount of activity, because the development of the femoral head is still immature and the joint capsule is loose. The height is sometimes higher than the child’s own ability to adapt, which can easily damage the synovial membrane of the hip joint.  Therefore, children should always be taught not to jump from high places and to control their activities appropriately. It is also important to keep children warm in winter to avoid wind chill or cold to protect their health.  At present, the treatment for children with transient hip synovitis generally adopts bed rest, skin traction and other conservative therapies, and Chinese medicine still has manipulation therapy. The main purpose is to reduce the pressure on the hip joint to prevent the blood supply to the femoral head from becoming too high in the long term.