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Diagnosis of COVID-19 associated arthritis in patients with or without underlying rheumatic and musculoskeletal disease supported by musculoskeletal ultrasound: a case series from three European centres


1, 2, 3, 4, 5, 6, 7, 8

 

  1. Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Germany.
  2. Department of Biotechnological and Applied Clinical Sciences, Università degli Studi dell' Aquila, Italy.
  3. Immunorheumatology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
  4. Rheumatology, Immunology, and Clinical Medicine Research Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Italy.
  5. Academic Rheumatology Centre, Università degli Studi di Torino, Italy.
  6. Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Germany.
  7. Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Germany.
  8. Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Germany. sarah.ohrndorf@charite.de

CER15643
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PMID: 35916289 [PubMed]

Received: 02/03/2022
Accepted : 19/05/2022
In Press: 28/07/2022

Abstract

OBJECTIVES:
The coronavirus disease 19 (COVID-19) pandemic concerns the field of rheumatology in many ways. Arthritis in conjunction with COVID-19 is increasingly reported. However, clinical data are still limited and there is lack of a detailed characterisation of COVID-19 associated arthritis by musculoskeletal ultrasound (MSUS). This case series reports different forms of COVID-19 associated arthritis supported by MSUS in patients with or without underlying rheumatic and musculoskeletal disease (RMD).
METHODS:
From March 2020 to July 2021, adult patients (n=10) with arthritis timely related to COVID-19 were assessed in three European centres by clinical and laboratory values and additionally MSUS.
RESULTS:
In the group without underlying RMD (n=6), two patients presented with polyarticular arthralgia during severe COVID-19, swelling was rarely seen and MSUS demonstrated arthritis only in a few joints affected. The other four patients showed arthritis four to 16 weeks after mild or moderate COVID-19 (without hospitalisation): polyarthritis (n=1), oligoarthritis of the upper and lower limb (n=2), and in one case, late-onset rheumatoid arthritis (LORA) was newly diagnosed. In the group with an underlying RMD (n=4), an increase of disease activity was reported by MSUS during mild and mild-moderate COVID-19. In general, MSUS often presented power Doppler (PD) positive synovitis and tenosynovitis.
CONCLUSIONS:
In our patients without underlying RMD, arthritides associated with COVID-19 are comparable to the clinical picture of a reactive arthritis (ReA) or other virus-related arthritides (e.g. parvovirus B19). New onset or flares of RMD possibly triggered by COVID-19 are noteworthy.

DOI: https://doi.org/10.55563/clinexprheumatol/an1yrh

Rheumatology Article

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