Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Medscanlagos Diagnóstico por imagem, Cabo Frio, RJ, Brasil.
Rev Soc Bras Med Trop. 2024 May 27;57:e004062024. doi: 10.1590/0037-8682-0090-2024. eCollection 2024.
Musculoskeletal inflammatory lesions in chronic Chikungunya virus (CHIKV) infection have not been thoroughly assessed using whole-body magnetic resonance imaging (WBMRI). This study aimed to determine the prevalence of these lesions in such patients.
From September 2018 to February 2019, patients with positive Chikungunya-specific serology (Immunoglobulin M/Immunoglobulin G anti-CHIKV), with a history of polyarthralgia for > 6 months prior to MRI with no pre-existing rheumatic disorders, underwent 3T WBMRI and localized MRI. The evaluation focused on musculoskeletal inflammatory lesions correlated with chronic CHIKV infection. Pain levels were assessed using a visual analogue scale on the same day as WBMRI.
The study included 86 patients of whom 26 met the inclusion criteria. All patients reported pain and most (92.3%) categorized it as moderate or severe. The most common finding across joints was effusion, particularly in the tibiotalar joint (57.7%) and bursitis, with the retrocalcaneal bursa most affected (48.0%). Tenosynovitis was prevalent in the flexor compartment of the hands (44.2%), while Kager fat pad and soleus edema were also observed. Bone marrow edema-like signals were frequently seen in the sacroiliac joints (19.2%). Most WBMRI findings were classified as mild.
This study represents the first utilization of 3T WBMRI to assess musculoskeletal inflammatory disorders in chronic CHIKV infection. The aim was to identify the most affected joints and prevalent lesions, providing valuable insights for future research and clinical management of this condition regarding understanding disease pathophysiology, developing targeted treatment strategies, and using advanced imaging techniques in the assessment of musculoskeletal manifestations.
慢性基孔肯雅热病毒（CHIKV）感染患者的肌肉骨骼炎症性病变尚未通过全身磁共振成像（WBMRI）进行全面评估。本研究旨在确定此类患者中这些病变的发生率。
从 2018 年 9 月至 2019 年 2 月，对具有阳性基孔肯雅特异性血清学（免疫球蛋白 M/免疫球蛋白 G 抗-CHIKV）、在 MRI 检查前有 >6 个月的多关节炎病史且无先前存在的风湿性疾病的患者进行 3T WBMRI 和局部 MRI 检查。评估重点是与慢性 CHIKV 感染相关的肌肉骨骼炎症性病变。在进行 WBMRI 的同一天，使用视觉模拟量表评估疼痛程度。
该研究纳入了 86 例患者，其中 26 例符合纳入标准。所有患者均报告有疼痛，大多数（92.3%）将其归类为中度或重度。关节最常见的表现是积液，尤其是在跗骨间关节（57.7%）和滑囊炎，其中跟后滑囊炎最常见（48.0%）。屈肌腱鞘炎在手的屈肌间隙中很常见（44.2%），同时也观察到 Kager 脂肪垫和比目鱼肌水肿。骨骨髓水肿样信号在骶髂关节中很常见（19.2%）。大多数 WBMRI 发现被归类为轻度。
本研究首次利用 3T WBMRI 评估慢性 CHIKV 感染中的肌肉骨骼炎症性疾病。目的是确定受影响最严重的关节和常见病变，为该疾病的未来研究和临床管理提供有价值的见解，包括了解疾病病理生理学、制定针对该疾病的治疗策略，以及在评估肌肉骨骼表现时使用先进的成像技术。
