Chikungunya Fever: Comparison Study of Synovitis and Tenosynovitis of the Hands and Wrists Using Physical Examination, Ultrasound, and <scp>MRI</scp> Findings

Leidersnaider, Caio Leal; Sztajnbok, Flávio; Coutinho, Evandro Silva Freire; Vaz, João Luiz Pereira; Porangaba, M.; Hamdan, Paulo Cesar; Martins, Pedro Ribeiro; Constantino, Carolina Pesce Lamas; Ancillotti, Roger Vinicius; Messeder, Alexandre Malta da Costa; Monteiro, Débora Guimarães; Folly, Mayara Malta; Mogami, Roberto

doi:10.1002/jum.15766

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…Similarly, in another study that evaluated hands and wrists of 50 patients with chronic musculoskeletal symptoms secondary to CHIKF in Brazil, synovitis was the most common finding (84.0%) [ 35 ]. Furthermore, a recent study confirmed that US could be of great value in confirming clinical findings in CHIKF patients, with the advantage of being a non-invasive, low-costing, and accessible exam [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort

et al. 2023

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Background Chikungunya-fever (CHIKF) remains a public health major issue. It is clinically divided into three phases: acute, post-acute and chronic. Chronic cases correspond to 25–40% individuals and, though most of them are characterized by long-lasting arthralgia alone, many of them exhibit persistent or recurrent inflammatory signs that define post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD). We aimed to identify early clinical markers of evolution to pCHIKV-CIJD during acute and post-acute phases. Methodology/Principal findings We studied a prospective cohort of CHIKF-confirmed volunteers with longitudinal clinical data collection from symptoms onset up to 90 days, including a 21-day visit (D21). Of 169 patients with CHIKF, 86 (50.9%) completed the follow-up, from whom 39 met clinical criteria for pCHIKV-CIJD (45.3%). The relative risk of chronification was higher in women compared to men (RR = 1.52; 95% CI = 1.15–1.99; FDR = 0.03). None of the symptoms or signs presented at D0 behaved as an early predictor of pCHIKV-CIJD, while being symptomatic at D21 was a risk factor for chronification (RR = 1.31; 95% CI = 1.09–1.55; FDR = 0.03). Significance was also observed for joint pain (RR = 1.35; 95% CI = 1.12–1.61; FDR = 0.02), reported edema (RR = 3.61; 95% CI = 1.44–9.06; FDR = 0.03), reported hand and/or feet small joints edema (RR = 4.22; 95% CI = 1.51–11.78; FDR = 0.02), and peri-articular edema observed during physical examination (RR = 2.89; 95% CI = 1.58–5.28; FDR = 0.002). Furthermore, patients with no findings in physical examination at D21 were at lower risk of chronic evolution (RR = 0.41, 95% CI = 0.24–0.70, FDR = 0.01). Twenty-nine pCHIKV-CIJD patients had abnormal articular ultrasonography (90.6% of the examined). The most common indings were synovitis (65.5%) and joint effusion (58.6%). Conclusion This cohort has provided important insights into the prognostic evaluation of CHIKF. Symptomatic sub-acute disease is a relevant predictor of evolution to chronic arthritis with synovitis, drawing attention to joint pain, edema, multiple articular involvement including small hand and feet joints as risk factors for chronification beyond three months, especially in women. Future studies are needed to accomplish the identification of accurate and early biomarkers of poor clinical prognosis, which would allow better understanding of the disease’s evolution and improve patients’ management, modifying CHIKF burden on global public health.

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Section: Discussionmentioning

confidence: 99%

Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort

et al. 2023

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“…Nine patients had normal baseline radiographs, but MRI revealed erosions in the hands of five of the six patients with normal radiographs. Leidersnaider et al 21 examined joint involvement in 30 patients (26 women) with CCA with ages ranging from 32 to 73 years (mean age 54.7 ± 10.0 years) using physical examination, ultrasonography, and MRI. The mean time from diagnosis to ultrasonography was 336.1 ± 251.7 days, ranging from 53 to 911 days, and the mean time from diagnosis to MRI was 337.5 ± 251.7 days, ranging from 54 to 913 days.…”

Section: • Study Findingsmentioning

confidence: 99%

Bone erosions and joint damage caused by chikungunya virus: a systematic review

Amaral,

Taylor,

Schoen

2024

Rev. Soc. Bras. Med. Trop.

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Background: Chikungunya fever is an emerging global infection transmitted by Aedes mosquitoes that manifests as an acute febrile illness with joint pain and can lead to chronic arthritis. The mechanism underlying chronic joint damage remains unclear; however, chronic chikungunya arthritis shares similarities with rheumatoid arthritis. Disease-modifying antirheumatic drugs have revolutionized rheumatoid arthritis treatment by preventing joint damage. However, the role of these therapies in chronic chikungunya arthritis has not been determined. We conducted a systematic review to evaluate the burden of joint structural damage in chronic chikungunya arthritis to help to define the role of disease-modifying therapy in this disease. Methods: This systematic review included retrospective and prospective studies, trials, and case reports evaluating joint damage caused by chikungunya virus. Various databases were searched without any date or language restrictions. Study selection was conducted independently by two researchers, and data were extracted from the articles selected. Results: A total of 108 studies were initially evaluated, with 8 meeting the inclusion criteria. Longitudinal studies have reported persistent joint pain from chikungunya infection and the progression of radiographic joint damage up to 13 years post-infection. Joint imaging revealed synovial inflammation, bone erosion, and cartilage destruction in patients with chronic chikungunya arthritis. Conclusions: Few studies have addressed chikungunya-induced joint damage, limiting our understanding of chronic chikungunya arthritis. Nevertheless, chronic chikungunya arthritis has similarities to rheumatoid arthritis. The success of early disease-modifying antirheumatic drug therapy in rheumatoid arthritis underscores the need for comprehensive research on its role in chikungunya arthritis.

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Contribution of imaging in the diagnosis of three neglected diseases in the Southern Cone: Leishmaniasis, Dengue, and Chikungunya

Galeano,

Ranalletti,

Pelizzari

et al. 2024

Pediatr Radiol

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Chikungunya Fever: Comparison Study of Synovitis and Tenosynovitis of the Hands and Wrists Using Physical Examination, Ultrasound, and MRI Findings

Cited by 4 publications

References 25 publications

Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort

Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort

Bone erosions and joint damage caused by chikungunya virus: a systematic review

Contribution of imaging in the diagnosis of three neglected diseases in the Southern Cone: Leishmaniasis, Dengue, and Chikungunya

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