Clinical features and ultrasound imaging of acute joint symptoms in Chikungunya fever patients

HAN Xiaohua; TANG Shiqi; OUYANG Jingcong; MAI Aixin; DENG Mengsi; XIE Qianru; ZHANG Guangjun; LI Yunfeng; LI Hong; QIN Tao; HE Chaohong

doi:10.12122/j.issn.1674-4500.2025.12.08

Abstract：Objective To investigate the articular clinical features and ultrasonographic changes in patients with acute Chikungunya fever(CHIKF).Methods This prospective study included 26 patients with CHIKF confirmed by nucleic acid testing and admitted to our hospital from August 8th to 31st,2025.All patients underwent musculoskeletal ultrasound examination of the limb joints and surrounding soft tissues The examination included small joints of the hands and feet,as well as the wrists,elbows,shoulders,ankles,knees,and hips,covering 52 joint sites in total.Results Ultrasonographic abnormalities were observed as follows:effusion in the small joints of the feet(100%,52/52)and synovitis(42.3%,22/52);effusion in the small joints of the hands(100%,52/52)and synovitis(38.5%,20/52);ankle joint effusion(34.6%,18/52)and synovitis(25%,13/52);wrist joint effusion(30.8%,16/52)and synovitis(25%,13/52);knee joint effusion(13.5%,7/52)and synovitis(7.7%,4/52);elbow joint effusion(19.2%,10/52)and synovitis(3.8%,2/52).No significant effusion or synovial hyperplasia was detected in the shoulder or hip joints.Additionally,the following findings were noted:finger tenosynovitis(3.8%,2/52),medial calf panniculitis(38.5%,20/52),soleus myositis in one case(1.9%,1/52),axillary lymphadenopathy(65.4%,34/52),and inguinal lymphadenopathy(86.5%,45/52).Conclusion Musculoskeletal ultrasound is effective in detecting joint alterations caused by CHIKF and can clearly visualize pathological changes in periarticular soft tissues,providing an objective and reliable basis for the diagnosis of articular involvement during the acute CHIKF.