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YOSEF UZIEL, YONATAN BUTBUL-AVIEL, JUDITH BARASH, SHAI PADEH, MASZA MUKAMEL, NATALIA GORODNITSKI, RIVA BRIK, and PHILIP J. HASHKES ABSTRACT. Methods. A retrospective chart review of children with at least 2 separate episodes of TS between 1986 and 2003. We described the diagnostic investigations and outcome of these patients. A followup telephone survey for disability and pain scores was performed in 2004. Results. We studied 39 children, 26 boys and 13 girls, from 6 pediatric rheumatology centers. The mean age at initial episode was 6 ± 2.6 years. There were a total of 102 episodes (mean 2.9 ± 1.6, median 2, range 2–10). All but 2 children had normal plain radiographs of the hip. All patients were contacted 4.2 ± 2.5 years after the first episode. None developed clinical Perthes disease or other chronic orthopedic condition. Three (8%) patients developed chronic disease: one had familial Mediterranean fever and 2 developed spondyloarthropathies, 0.5, 2, and 6 years after presentation. At followup 26 of 36 patients were asymptomatic, and 10 reported rare hip pain after intensive physical effort. Conclusion. Children with recurrent TS usually have a benign course. In some patients recurrent TS may be the presenting feature of a chronic inflammatory condition. No progression to chronic orthopedic conditions was observed. (J Rheumatol 2006;33:810–11) Key Indexing Terms: TRANSIENT SYNOVITIS
From the Department of Pediatrics, Pediatric Rheumatology, Meir Medical Center, Kfar Saba; Tel Aviv University, Tel Aviv; Ha'Emek Medical Center, Afula; Kaplan Medical Center, Rehovot; Hebrew University, Jerusalem; Sheba Medical Center, Ramat Gan; Schneider Children's Hospital, Petah-Tikva; Rambam Medical Center; Technion Medical School, Haifa, Israel; Cleveland Clinic Foundation, Cleveland, Ohio, USA; and the Pediatric Rheumatology Study Group of Israel. Y. Uziel, MD, MSc, Senior Clinical Lecturer, Pediatric Rheumatology, Department of Pediatrics, Meir Medical Center, Tel Aviv University; Y. Butbul-Aviel, MD, Instructor, Ha'Emek Medical Center; J. Barash, MD, Lecturer, Kaplan Medical Center, Hebrew University; S. Padeh, MD, Senior Clinical Lecturer, Sheba Medical Center, Tel Aviv University; M. Mukamel, MD, Senior Clinical Lecturer, Schneider Children's Hospital, Tel Aviv University; N. Gorodnitski, MD, Pediatric Rheumatology, Department of Pediatrics, Meir Medical Center, Tel Aviv University; R. Brik, MD, Associate Professor of Pediatrics, Rambam Medical Center, Technion Medical School; P.J. Hashkes, MD, MSc, Cleveland Clinic Foundation. Address reprint requests to Dr. Y. Uziel, Department of Pediatrics, Meir Medical Center, Kfar-Saba, Israel, 44281. E-mail: uziely@zahav.net.il Accepted for publication November 25, 2005.
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