Asche Sylvana S, van Rijn Rogier M, Bessems Johannes Hjm, Krul Marjolein, Bierma-Zeinstra Sita Ma
Department of General Practice, Erasmus MC-University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Chiropr Man Therap. 2013 Nov 14;21(1):39. doi: 10.1186/2045-709X-21-39.
Transient synovitis of the hip (TS) is considered to be a self-limiting disease in childhood. However, because the etiology is unclear and some cases precede Legg-Perthes' disease, data on follow-up are important. Our aim was to summarize the knowledge on the clinical course of TS in children.
The study design was a systematic review and a literature search was conducted in Medline and Embase. Studies describing short and/or long-term follow-up of TS in children were included. Case reports, reviews and studies describing traumatic hip pain were excluded. Study quality was scored and data extraction was performed. The main outcome measures were short-term and long-term clinical course, and recurrence of symptoms.
A total of 25 studies were included of which 14 were of high quality. At two-week follow-up, almost all children with TS were symptom free. Those with symptoms persisting for over one month were more prone to develop other hip pathology, such as Legg-Perthes' disease. The recurrence rate of TS ranged from 0-26.3%. At long-term follow-up, 0-10% of the children diagnosed with TS developed Legg-Perthes' disease. Hip pain after intensive physical effort and limited range of motion of the hip at long-term follow-up was reported in 12-28% and in 0-18% of the children, respectively.
The majority of the studies indicate that children with TS recover within two weeks; recurrence was seen in 0-26% of the cases. Children with TS should be followed at least six months to increase the likelihood of not missing Legg-Perthes' disease.
儿童髋关节一过性滑膜炎（TS）被认为是一种自限性疾病。然而，由于病因不明且部分病例先于Legg-Perthes病出现，随访数据很重要。我们的目的是总结关于儿童TS临床病程的知识。
研究设计为系统评价，并在Medline和Embase中进行文献检索。纳入描述儿童TS短期和/或长期随访的研究。排除病例报告、综述以及描述创伤性髋关节疼痛的研究。对研究质量进行评分并进行数据提取。主要结局指标为短期和长期临床病程以及症状复发情况。
共纳入25项研究，其中14项质量较高。在两周随访时，几乎所有TS患儿均无症状。症状持续超过1个月的患儿更易发生其他髋关节病变，如Legg-Perthes病。TS的复发率为0 - 26.3%。在长期随访中，诊断为TS的患儿中有0 - 10%发生Legg-Perthes病。分别有12 - 28%和0 - 18%的患儿在长期随访时报告有剧烈体力活动后髋关节疼痛和髋关节活动范围受限。
大多数研究表明，TS患儿在两周内康复；0 - 26%的病例出现复发。TS患儿应至少随访6个月，以增加不遗漏Legg-Perthes病的可能性。
