Toxic Synovitis

You guys. Poor, poor Mabel. I shared recently how we had been dealing with a massive ear infection/allergic reaction- but that wasn’t the end of Mabel’s troubles!

Last Tuesday morning, I was in Finn’s room nursing him when I heard the girls wake up. Shortly thereafter, I heard wailing and crying from Mabel and Abigail coming in to tell me that Mabel said she couldn’t get out of bed.

I finished up with Finn and left him with Abigail and went to see what was happening with Mabel. She was laying flat on her back in her bed, positively sobbing, telling me that she was hurting and couldn’t get out of bed.

Now, I’ll admit to being a cynic so I was pretty sure I was being toddler punked by a kid who just wanted to be carried everywhere and/or not get out of bed and play the iPad. So I tried to lure her out of bed with the promise of pancakes and various other Mabel loves, but she wouldn’t move.

Then I decided to take her to the bathroom and change her out of her pull-up and that brought on a chorus of painful screaming and crying, something that I have never heard from her before.

I started to think that maybe something really was wrong.

I let her stay in her bed while I fixed breakfast and thought about what to do (which is, call my Mom). She said to call the pediatrician to see what they say about it. (Mabel didn’t have a fever, hadn’t fallen recently, had zero visible swelling or bruises, had a hearty appetite, and as long as I didn’t move her- seemed to be her usual self) So, I called to explain everything to the nurse. She agreed that it seemed very strange and told me to go ahead and start giving her ibuprofen. Unfortunately, they couldn’t see Mabel until 2pm(nap time, blah!) but that was literally all they had available that day, so we waited.

I could barely get in to the pediatricians office with my three children- I had to have Abigail push the stroller with Finn in it, and I had to carry a screaming and crying in pain Mabel. It was a total circus.

The Dr. checked her out and basically concluded the same things that I had already noticed- that something was definitely, definitely wrong- but what? She refused to bear weight on her legs for the Dr. and her legs and feet were cold and starting to swell/be painful because she refused to move them. Fortunately she had a strong pulse in them, but it was still concerning to the Dr.

SO she sent us over to the hospital to get x-rays to see what in the world was going on.

I had to have help back out to my van and then I had to call Jim and have him meet me at the hospital, because there was absolutely no way I could get the four of us inside and really no way to be with her for x-rays too. He got there around 3 p.m. and in we went.

The kids couldn’t be in the room so I stayed and nursed Finn and kept Abigail while Jim took her back for her scans. I could hear her screaming and crying in pain down the hall. It was absolutely HORRIBLE. (On top of it being well beyond nap time and overdue for ibuprofen)

After they finished with her they were like, “okay bye!” and Jim and I just stood there like….aren’t they going to tell us what is wrong???? So he asked and they said, “Oh, you’ll hear within 2-3 business days”


I promptly called the pediatrician’s office to wave my ferocious mama bear flag and they said they would be figuring it all out a.s.ap.

So, while we waited to hear what was going on inside our Mabel, we took her home for medicine and sleep. The medicine she gladly accepted, but sleep couldn’t come. We tried laying her down in her bed but she was just in SO MUCH PAIN. She was most comfortable in a sitting position(not exactly ideal for sleeping) so we moved her down to the couch and set her up on a pillow throne so she could try to rest.

FINALLY around 5 p.m. the office called us back with the results of her scans.

Fluid on her hip. A virus.

Toxic Synovitis.

A bit of info about Toxic Synovitis from Kid’s Health:

What Is Toxic Synovitis?

Toxic synovitis has a scary name, but it’s not a scary condition. This temporary inflammation of the hip can cause limping and pain in the hip and leg. This can be unpleasant for a child and unsettling for a parent — especially when symptoms start suddenly — but toxic synovitis usually goes away within a week or two, and causes no long-term problems.

What Causes Toxic Synovitis?

Toxic synovitis (also known as transient synovitis) is a common cause of hip pain and limping in children. Doctors don’t know its exact cause, but some kids develop it after having a viral infection (such as a cold or diarrhea). Because of this, some doctors think that toxic synovitis is caused by substances made by the body’s immune system to fight the infection.

Toxic synovitis can happen at any age, but is most common in kids between 3 and 8 years old. It’s also more common in boys.

What Are the Signs & Symptoms of Toxic Synovitis?

When kids have toxic synovitis, the pain starts suddenly and usually is only on one side of the body.

Other signs to look for:

  • a recent viral infection, such as a cold or stomach virus
  • low-grade fever (up to 101°F [38°C])
  • limping with toes turned outward, the knee bent or straightened
  • walking on tiptoes
  • hip discomfort after a long period of resting the joint (such as sitting in a car or at a desk, or watching TV)
  • knee or thigh pain with no hip pain
  • in younger children, crying
  • in some cases, a refusal to walk

How Is Toxic Synovitis Diagnosed?

The first thing a doctor will do is examine your child, checking to see what kind of movement is painful by moving the knee, the hip, and other joints. This is to confirm that the limping is caused by joint pain.

Next, the doctor may order an ultrasound of the hip. This imaging test will show whether there is fluid in the hip joint. Fluid means there is swelling and inflammation of the tissues. The doctor also may do blood tests to see how much swelling there is.

Sometimes, the blood test results make it hard for the doctor to rule out septic arthritis, so fluid might be taken from the joint for a culture (a lab test to detect bacteria). The doctor also may do other tests and X-rays to look for or rule out other potential causes of your child’s limping and pain.

How Is Toxic Synovitis Treated?

Treatment for toxic synovitis usually includes anti-inflammatory drugs such as ibuprofen or naproxyn. Your child may take these for up to 4 weeks until the inflammation goes away. The doctor also may prescribe medicine for pain, such as acetaminophen.

Resting the hip joint is important, and it’s best if your child avoids putting weight on the hip while recovering. Kids usually can walk again comfortably within a day or two of taking the anti-inflammatory medicine. However, participation in activities like gym class or sports will have to wait until your child fully recovers.

What Else Should I Know?

Toxic synovitis usually goes away within a week or two, but sometimes can last for 4-5 weeks.

Basically, the nurse told me that we don’t know HOW or WHY she got it, but that she has it and how to treat it. (Though, we do suspect her immune system having been down from her ear infection fiasco)

The next few days were absolutely awful. The ibuprofen wasn’t even touching her pain so we started alternating tylenol as well. Jim “slept” down on the couch with her. The first night she was hurting so much, she didn’t fall asleep until 4 a.m. The next night she didn’t fall asleep until 11 p.m. and her usual nap routine was a mess as well.

FINALLY five days into the virus, she started to turn a corner. She finally walked a little and could sleep in her bed again. On Sunday, six days into the virus, she slept in until 9:15 and took a FOUR HOUR NAP to catch up on the sleep she had been missing. On Monday, she was running laps around the house again but dissolved into tears of pain at bedtime again.

Some people warned me that she can rally and then get worse again, which definitely seems to be the case. The pediatrician also said that she will set her own pace for healing- so if she feels better, she’ll get up. If she hurts, she’ll rest.

A few things we have learned:

If we could get her to the bathtub, warm water helped.

It is very important for her comfort to stay on top of alternating her medicines.

Keeping her comfortable on the couch, sitting felt best.

Watching lots and lots and lots of shows and movies together was the best way to pass the time.

To be patient while her little body fights the virus(it feels like it took forever)- there is a risk of infection, which could cause a fever to spike and require the use of antibiotics, so we were hoping and praying to avoid that!

The night that we got her home and settled after the hospital drama, Jim and I just held each other and cried. Seeing her in pain like that about broke us both and the hours of unknown waiting to find out what was wrong with her was awful. We had both been internally battling back the fears of all of the worst case scenarios for our little girl and that night the weight of that just burst out.

We are so thankful though, that as terrible and no fun at all that this entire experience has been, that it was JUST a virus and that it ONLY lasted for days, and then it’s back to business as usual.

Our family has never really dealt with health issues before(like, ever) so dealing with Mabel and this last month or so of back to back sickness and issues has been pretty eye opening and certainly reminded us to be thankful for the health that we typically have and to be more compassionate for those we know who don’t.

But, all of that to say, we love our Mabel girl so much and we are so grateful that she is going to be okay and back to her silly, bouncy, crazy self sooner rather than later.

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  1. Poor Mabel! What a scary experience. I’ve never heard of this condition before. The fact that it drags on for days and the kids are in so much pain sounds just awful. So glad she’s feeling better. April better be extra kind to Mabel!

  2. Oh my goodness. Poor baby. I cannot even imagine thr pain. I struggle with a chronic leg/hip issue and I cant imagine that as a child. I will send prayers your way and hope she (and you all) are getting back to a normal pace.

  3. I found your blog tonight in a desperate attempt for info as I listen to my 11 hear old son wail in pain from the same diagnosis. We were at a walk in clinic and then Emergency department Saturday. Sunday he seemed a lot better, but just woke at 12am acreaming. I’m hoping that it is just the viral form and not bacterial, but keeping an eye on it. Thank you for sharing your experience with this.

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