Clinical profiles of post-infectious arthritis and transient synovitis of the hip in children

Pediatr Int. 2022 Jan;64(1):e15237. doi: 10.1111/ped.15237.


Background: Acute inflammatory arthritides can present as a result of immune reaction following infections. Post-infectious arthritis and transient synovitis of the hip in children are included in this disease entity. The aim of this study was to describe the clinical profiles of post-infectious arthritis and transient synovitis of the hip in Thai children.

Methods: A retrospective review was performed at a tertiary care hospital in Bangkok, Thailand from January 2005 to July 2017.

Results: Eighty-six patients (56 boys and 30 girls) were included in this study. Mean age was 8.4 ± 4.8 years. Reactive arthritis was diagnosed in two patients (2.3%) following Salmonella spp. and Chlamydia trachomatis infections. Post-streptococcal reactive arthritis was present in 10 patients (11.6%). Transient synovitis of the hip was found in 30 patients (34.9%). Forty-four patients (51.2%) were clinically diagnosed with post-infectious arthritis. Mono/oligoarthritis was the most common clinical profile (84.9%). The distribution of lower-extremity involvement was as follows: hip, 47.6%; knee, 46.5%; and ankle joints, 30.2%. The documented preceding illness consisted mostly of upper respiratory tract symptoms (30.2%). Non-steroidal anti-inflammatory drugs were prescribed for 70 patients (81.4%).

Conclusion: Mono/oligoarthritis of the lower extremity was the main clinical profile. Preceding viral illness was documented in one-third of children. Reactive arthritis was rarely seen.

Keywords: children; post-infectious arthritis; post-streptococcal reactive arthritis; reactive arthritis; transient synovitis of the hip.

MeSH terms

  • Adolescent
  • Arthritis, Infectious* / diagnosis
  • Arthritis, Infectious* / epidemiology
  • Arthritis, Infectious* / etiology
  • Arthritis, Reactive* / diagnosis
  • Arthritis, Reactive* / drug therapy
  • Arthritis, Reactive* / epidemiology
  • Blood Sedimentation
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Hip Joint
  • Humans
  • Male
  • Synovitis* / diagnosis
  • Synovitis* / etiology
  • Thailand