MR imaging of transient synovitis: differentiation from septic arthritis

  title={MR imaging of transient synovitis: differentiation from septic arthritis},
  author={Wan Jik Yang and Soo Ah Im and Gye Yeon Lim and Ho Jong Chun and Na Young Jung and Mi Sook Sung and Byung Gil Choi},
  journal={Pediatric Radiology},
BackgroundTransient 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.ObjectiveTo describe the MR findings of transient synovitis and to determine whether the MR characteristics can differentiate this disease entity from septic arthritis.Materials and methodsClinical findings and MR images of 49 patients with… 
Septic arthritis versus transient synovitis of the hip: gadolinium-enhanced MRI finding of decreased perfusion at the femoral epiphysis.
Low signal intensity on fat-suppressed gadolinium-enhanced coronal T1-weighted coronal MRI suggesting decreased perfusion at the femoral head of the affected hip joint was seen in eight of nine patients with septic arthritis and in two of 11 patients with transient synovitis.
Differential MRI findings of transient synovitis of the hip in children when septic arthritis is suspected according to symptom duration
The significances of differential MRI findings for septic arthritis and transient synovitis seem to change according to symptom duration, which may correlate with disease progression, and it is suggested that symptom duration should also be considered when interpreting MRIs of children under suspicion of septicthritis.
Usefulness of dynamic contrast-enhanced MRI in differentiating between septic arthritis and transient synovitis in the hip joint.
DCE-MRI is useful in differentiating between septic hip arthritis and transient synovitis and the optimal time for the acquisition of contrast-enhanced coronal MRI is approximately 3.5 minutes.
Post-arthrogram synovitis: MRI and histopathologic findings
A 57-year-old patient developed severe, persistent pain following MR arthrography with iodinated contrast, and is believed to be an unusually severe case of reactive synovitis.
MR findings of synovial disease in children and young adults: Part 2
Synovium is the thin membranous lining of a joint. It produces synovial fluid, which lubricates and nourishes the cartilage and bone in the joint capsule. Synovial diseases in children can be
Concomitant septic arthritis and osteomyelitis of the hip in young children; a new pathophysiological hypothesis suggested by MRI enhancement pattern
Age under one year and decreased perfusion of the affected femoral epiphysis increases the risk of secondary AHO, the first report in human medicine supporting the physiopathological hypothesis described by Alderson et al. in an animal model.
Differences in MRI findings between subgroups of recent-onset childhood arthritis
In children with high clinical suspicion of recent onset arthritis, there was a significant difference in the distribution of specific MRI features among the diagnostic groups.
Toxic synovitis
Differential between septic arthritis and TS is challenging as both may present in young children with pain, limp, and limited motion of the hip, and both present in similar populations, often with similar histories.
Transient synovitis of the hip: a comprehensive review.
Transient synovitis is a benign, self-limiting condition that is diagnosed after the exclusion of more serious causes of acute hip pain in children, and is largely believed to be viral in nature.
The right hip is the most involved joint and the majority of patients have the history of recent viral diseases, which is more common in boys.


Septic arthritis versus transient synovitis at MR imaging: preliminary assessment with signal intensity alterations in bone marrow.
Signal intensity alterations in the bone marrow of the affected hip joint are useful in the differentiation of septic arthritis from transient synovitis.
Significance of Laboratory and Radiologic Findings for Differentiating Between Septic Arthritis and Transient Synovitis of the Hip
The authors conclude that the independent multivariate predictors are effective indices for the differential diagnosis of acute septic coxitis and transient synovitis.
MR Findings of Transient Synovitis of the Hip
The MR findings of transient synovitis of the hip in children were normal bone marrow signal intensity of the femoral head, moderate or strong synovial enhancement, and asymmetric hip joint effusion.
Transient synovitis of the hip in children: role of US.
The authors retrospectively studied the value of hip arthrosonography in 46 children with clinical symptoms suggesting pathologic hip conditions, and found increased echogenicity of the articular fluid was found in both transient synovitis and septic arthritis.
Joint effusion in children with an irritable hip: US diagnosis and aspiration.
Clinical evaluation, radiographs, and sonograms together determined the need for US-guided aspiration, which allowed selection of only those with septic arthritis for operative drainage and shortened that procedure.
Ultrasound in the diagnosis and follow-up of transient synovitis of the hip.
Of 59 patients (2-15 years of age) with acute synovitis of the hip, one patient developed Perthes disease (1.7%) and the others transient synovitis. The diagnostic criterion for intracapsular
The septic versus nonseptic inflamed joint: MRI characteristics
The combination of bone erosions with marrow edema is highly suggestive for a septic articulation; the additional coexistence of synovial thickening,synovial edema, soft tissue edema or bone marrow enhancement increases the above level of confidence.
Magnetic resonance imaging in children with acute hip pain
MRI was the only imaging technique able to give an early indication of bone marrow involvement in systemic diseases and as sensitive as isotope bone scan and more precise than conventional radiography for the early diagnosis of LCPD.
It is significant that since the attention has been focused on this syndrome the diagnosis has been made seven times in the past two years, although the subsequent course and ultimate prognosis in the two conditions are vastly different.