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

J Ultrasound Med. 2022 Apr;41(4):865-873. doi: 10.1002/jum.15766. Epub 2021 Jun 25.

Abstract

Objectives: To compare musculoskeletal changes on a physical examination (PE), ultrasound (US) and magnetic resonance imaging (MRI) of the hands and wrists of patients with Chikungunya fever (CF).

Methods: The sample consisted of 30 patients in the chronic phase of CF. The sites analyzed were the interphalangeal (IP), metacarpophalangeal (MCP) and wrist/mediocarpal (WMC) joints and periarticular soft tissue. The interval between the PE and imaging tests was 7 days, and the interval between US and MRI was 2 days. The kappa coefficient was calculated to estimate the agreement between the PE and US and MRI findings and between the US and MRI findings.

Results: Significant agreement was observed between PE and US in the diagnosis of synovitis. The only statistically significant agreement between US and MRI was the finding of flexor tenosynovitis; the agreement was moderate.

Conclusions: US has great potential for use in diagnosing synovitis suspected based on a PE. The limited agreement observed between US and MRI, in turn, may suggest a complementary role of these methods.

Keywords: Chikungunya fever; arthritis; magnetic resonance imaging; musculoskeletal; physical examination; ultrasound.

MeSH terms

  • Arthritis, Rheumatoid* / pathology
  • Chikungunya Fever* / complications
  • Chikungunya Fever* / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods
  • Physical Examination
  • Synovitis* / diagnostic imaging
  • Tenosynovitis* / diagnostic imaging
  • Wrist
  • Wrist Joint