HipTransient Synovitis: Lack of Serologic Evidence for Acute Parvovirus B-19 or Human Herpesvirus-6 InfectionLockhart, Gregory R. M.D.; Longobardi, Yen Loo M.D.; Ehrlich, Michael M.D.*Author Information Study conducted at Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, U.S.A. From the Department of Pediatric Emergency Medicine, and *Department of Orthopedics, Brown University School of Medicine, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, U.S.A. Address correspondence and reprint requests to Dr. G. R. Lockhart, Department of Pediatric Emergency Medicine, Hasbro Children's Hospital/Rhode Island Hospital, 593 Eddy Street, Davol 141, Providence, RI 02903, U.S.A. Journal of Pediatric Orthopaedics: March 1999 - Volume 19 - Issue 2 - p 185-187 Buy Abstract We evaluated children with transient synovitis for serologic evidence of infection with parvovirus B-19 (PVB-19) and human herpesvirus-6 (HHV-6) by using a prospective patient series in an urban children's hospital emergency department (ED). There were 20 children enrolled, aged 15 months to 6 years, diagnosed with transient synovitis. Clinical data were collected, and acute PVB-19 and HHV-6 immunoglobulin G (IgG) and IgM serologic titers were measured on all patients. Ten patients returned in 4-6 weeks for convalescent titers. The mean age was 4.1 years. Prodromal symptoms within a week of presentation were noted in 50% of patients, most commonly fever (25%) and upper respiratory infection (20%). Mean sedimentation rate was 11 mm/h (range, 2-22 mm/h), and mean peripheral white blood count was 11,000/μl (range, 6-21,000/μl). No patient had increased acute or convalescent IgM titers for either PVB-19 or HHV-6, and no patient who returned for follow-up had an increase in serum IgG titers for either virus. A majority of patients (80%) had increased acute HHV-6 IgG titers, reflecting prior immunity to this virus. In conclusion, there is no evidence in this series that acute infection with PVB-19 or HHV-6 causes or precedes transient synovitis. © 1999 Lippincott Williams & Wilkins, Inc.