A randomized clinical trial: should the child with transient synovitis of the hip be treated with nonsteroidal anti-inflammatory drugs?

Ann Emerg Med. 2002 Sep;40(3):294-9. doi: 10.1067/mem.2002.126171.


Study objectives: The diagnosis of transient synovitis of the hip ("irritable hip") is made frequently in the pediatric emergency department. We hypothesized that an anti-inflammatory agent (ibuprofen syrup) would shorten the duration of symptoms.

Methods: Patients who were clinically diagnosed with transient synovitis of the hip in the ED between July 1997 and July 1998 were randomized in a double-blind, placebo-controlled trial to receive either ibuprofen syrup (10 mg/kg 3 times a day for 5 days) or placebo. There were stringent exclusion criteria, and patients were only included if there was a low index of suspicion of more serious pathology. All patients had a hip ultrasonography performed at enrollment and at day 7. Symptoms were monitored by the use of a parental diary and clinical review.

Results: Forty patients were initially enrolled, but 4 patients were subsequently excluded, leaving 17 patients in the ibuprofen group and 19 in the placebo group. Although symptoms resolved in more than 80% (30 of 36) of patients in both groups by 7 days, the median duration of symptoms was shorter in the ibuprofen group (2 days compared with 4.5 days in the placebo group; P =.05 on Wilcoxon-Breslow test). The medication was well tolerated, with only minor gastrointestinal side effects being reported by 6 patients (4 ibuprofen and 2 placebo).

Conclusion: In this small study, ibuprofen shortened the duration of symptoms in children with a clinical diagnosis of transient synovitis of the hip.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Australia
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Hip Joint / diagnostic imaging
  • Humans
  • Ibuprofen / adverse effects
  • Ibuprofen / therapeutic use*
  • Synovitis / drug therapy*
  • Ultrasonography


  • Anti-Inflammatory Agents, Non-Steroidal
  • Ibuprofen