Original Article

Pediatric Radiology

, Volume 36, Issue 11, pp 1154-1158

First online:

MR imaging of transient synovitis: differentiation from septic arthritis

  • Wan Jik YangAffiliated withDepartment of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea
  • , Soo Ah ImAffiliated withDepartment of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea Email author 
  • , Gye-Yeon LimAffiliated withDepartment of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea
  • , Ho Jong ChunAffiliated withDepartment of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea
  • , Na Young JungAffiliated withDepartment of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea
  • , Mi Sook SungAffiliated withDepartment of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea
  • , Byung Gil ChoiAffiliated withDepartment of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea

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Abstract

Background

Transient 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.

Objective

To describe the MR findings of transient synovitis and to determine whether the MR characteristics can differentiate this disease entity from septic arthritis.

Materials and methods

Clinical findings and MR images of 49 patients with transient synovitis (male/female 36/13, mean age 6.1 years) and 18 patients with septic arthritis (male/female 10/8, mean age 4.9 years) were retrospectively reviewed.

Results

MR findings of transient synovitis were symptomatic joint effusion, synovial enhancement, contralateral joint effusion, synovial thickening, and signal intensity (SI) alterations and enhancement in surrounding soft tissue. Among these, SI alterations and enhancement in bone marrow and soft tissue, contralateral joint effusion, and synovial thickening were statistically significant MR findings in differentiating transient synovitis from septic arthritis.

Conclusions

The statistically significant MR findings in transient synovitis are contralateral (asymptomatic) joint effusions and the absence of SI abnormalities of the bone marrow. It is less common to have SI alterations and contrast enhancement of the soft tissues. The statistically significant MR findings in septic arthritis are SI alterations of the bone marrow, and SI alterations and contrast enhancement of the soft tissue. Ipsilateral effusion and synovial thickening and enhancement are present in both diseases.

Keywords

Transient synovitis Septic arthritis Hip MR Child