From the Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St, Suite 800, Chicago, IL 60611 (I.M.O., A.M.S.); Department of Radiology, University of New Mexico Health Sciences Center, Albuquerque, N.M. (J.S.W., M.S.T.); Department of Medical Imaging, Ann & Robert Lurie Children's Hospital, Chicago, Ill (J.D.S.); Department of Radiology, University of Illinois at Chicago College of Medicine, Chicago, Ill (W.A.M.); and Departments of Medical Imaging and Orthopaedics, University of Arizona College of Medicine, Tucson, Ariz (M.S.T.).
Radiographics. 2022 Sep-Oct;42(5):1415-1432. doi: 10.1148/rg.220036. Epub 2022 Jul 22.
COVID-19, the clinical syndrome produced by infection with SARS-CoV-2, can result in multisystem organ dysfunction, including respiratory failure and hypercoagulability, which can lead to critical illness and death. Musculoskeletal (MSK) manifestations of COVID-19 are common but have been relatively underreported, possibly because of the severity of manifestations in other organ systems. Additionally, patients who have undergone sedation and who are critically ill are often unable to alert clinicians of their MSK symptoms. Furthermore, some therapeutic measures such as medications and vaccinations can worsen existing MSK symptoms or cause additional symptoms. Symptoms may persist or occur months after the initial infection, known as post-COVID condition or long COVID. As the global experience with COVID-19 and the vaccination effort increases, certain patterns of MSK disease involving the bones, muscles, peripheral nerves, blood vessels, and joints have emerged, many of which are likely related to a hyperinflammatory host response, prothrombotic state, or therapeutic efforts rather than direct viral toxicity. Imaging findings for various COVID-19-related MSK pathologic conditions across a variety of modalities are being recognized, which can be helpful for diagnosis, treatment guidance, and follow-up. RSNA, 2022.
新型冠状病毒病(COVID-19)是由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染引起的临床综合征,可导致多系统器官功能障碍,包括呼吸衰竭和高凝状态,从而导致重症和死亡。COVID-19 的肌肉骨骼(MSK)表现较为常见,但报道相对较少,这可能是由于其他器官系统表现的严重程度所致。此外,接受镇静治疗且病情危重的患者通常无法向临床医生提示其 MSK 症状。此外,某些治疗措施,如药物和疫苗接种,可使现有 MSK 症状恶化或引起其他症状。症状可能在初始感染后持续存在或出现,称为新冠后状况或长新冠。随着全球对 COVID-19 的经验和疫苗接种工作的增加,出现了某些涉及骨骼、肌肉、周围神经、血管和关节的 MSK 疾病模式,其中许多可能与宿主的过度炎症反应、高凝状态或治疗措施有关,而不是直接的病毒毒性。目前正在认识各种与 COVID-19 相关的 MSK 病理情况的各种影像学表现,这有助于诊断、治疗指导和随访。RSNA,2022 年。