Hip > Synovitis

What is the Synovium?

The synovium is the protective membrane that covers all the bones, tendons, and cartilage in your hip. The synovial fluid is the lubricating fluid within the joint that helps the joint move smoothly.

Synovitis occurs when the synovial membrane becomes irritated or inflamed. The synovium swells and produces extra fluid as an attempt to protect the joint from damage. Particularly common in children ages three to ten is a condition called transient synovitis that lasts from ten days to a few weeks. It is the most common type of hip pain in children.

Traumatic and repeated injuries commonly cause synovitis. It usually accompanies an underlying joint injury that has chipped or roughened any of the surfaces in your hip. Joint diseases, especially rheumatoid arthritis and gout, can also cause synovitis. Transient synovitis in children may be caused by an allergic reaction to an infection somewhere in the body. You are most at risk of suffering synovitis in contact sports like football. The risk of synovitis also increases during all sports and activities after repeated hip injuries of any kind.

If synovitis is left untreated, your hip pain may continue to worsen, which can make movement increasingly difficult. Trying to ignore hip pain and swelling may result in a more serious, underlying condition going undiagnosed. Synovitis itself usually does not put you at risk of any dangerous complications, and physicians generally suggest healing with anti-inflammatory medication. If pain and swelling do not go away, a corticosteroid injection may be necessary.

There are usuallly three parts to an orthopedic evaluation: mediccal history, physical examination, and tests your physician may order.

Your physician may ask you about the following information to help make the diagnosis:

    Your age and history of other medical conditions.

   The nature of your pain – when it began; how long it lasts; its location and severity; whether it radiates; and any factors, like running or climbing stairs, that relieve or increase the pain.

   Your physical and athletic goals – information that will help determine what treatment might be best for you in achieving those goals.

   Whether you have fever, chills, weight loss, or other symptoms of illness.

The key to diagnosing synovitis is finding the underlying cause. While asking you questions to pinpoint your pain, physicians will also test ligament and tendon strength by checking your hip's range of motion. Your posture and ability to transfer weight usually is examined as you stand, sit, lie down, and stand again. The symmetry of your hips and the length of each leg may be measured. Your physician also checks for bruises, cuts, redness, or swelling. You may undergo a neurovascular examination to check your reflexes and pulse. Your physician may administer a number of muscular strength tests. While your leg is held with resistance from your physician, you may be asked to bend and rotate your hip in various directions to see what movements cause pain. Depending on what your physician suspects is causing synovitis, you may undergo further physical examination to diagnose arthritis, cartilage damage, or other hip problems.

Your physician usually takes a small blood sample with a needle to perform a complete blood count (CBC) or a rheumatoid factor analysis, which tests for rheumatoid arthritis. A urine sample may also be needed to rule out infections. Should your physician require a closer look, MRI (magnetic resonance imaging) is generally the best method for obtaining a clear picture of synovitis. MRI can sometimes be used to catch minor synovitis before the swelling becomes painful and visible to the eye. X-rays may also be taken of your hipbone, thighbone, and knee to check for any bone abnormalities. If your physician suspects synovitis, your physician may use a needle to remove some of the fluid from your hip which is then tested in the laboratory. Synovial fluid that is infected by synovitis has unique characteristics that can be tested to make the final diagnosis.

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