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OBJECTIVE: To describe the outcome of children with recurrent transient synovitis (TS) of the hip. 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.