Imaging findings in chikungunya fever

Imaging of Emerging Infectious Diseases

“…Ultrasound shows tenosynovitis involving the small joints of the fingers, bulging of the joint capsule (84%), wrist effusions with incompressible synovial thickening (74%), finger flexor tenosynovitis (70%), cellulitis, wrist extensor tenosynovitis (38%), and thickening of the median nerve (36%) (Fig. 3) [23,27]. MRI demonstrates similar findings, including tenosynovitis and polyarticular joint effusions, although erosive changes may be more apparent (Fig.…”

“…Chikungunya fever (CHIKF) is an infection caused by an RNA virus from the Togaviridae family transmitted to humans through the bite of infected Aedes aegypti and Aedes albopictus mosquitos [23], the same species responsible for the spread of Zika and Dengue viruses. The word ''chikungunya'' means to ''walk bent over'' in the Makonde language, spoken in southeast Tanzania and northern Mozambique, reflecting the severe arthralgia associated with the disease [24].…”

“…The virus was first isolated in 1955 following an outbreak on the Makonde Plateau in 1952. While periodic outbreaks have occurred over the last 50 years in Africa and Southeast Asia, large outbreaks in [23,25,26]. Cases in Brazil account for 94% of all confirmed cases in the Americas, and an additional large outbreak was described during the Olympic Games in Rio de Janeiro in 2016 [27].…”

“…2). Progression to the chronic phase, or ''chronic migratory rheumatism,'' occurs in approximately 50% of patients over a span of 3 months to 3 years [23,26,27]. High expression of prostaglandins stimulates nociceptors that increase sensitivity to pain and increase osteoclastic activity, resulting in osseous erosion [28].…”

“…Additional sites of inflammation include lymph nodes, skin, liver, and spleen [29]. The chronic phase of disease is typically distal, symmetric, and polyarticular, involving the hands, wrists, and ankles [23]. Less common neurologic outcomes include seizure, encephalitis with decreased limb movements and extensor plantar response, and neuropathic pain [27].…”