Patterns of Musculoskeletal Manifestations in Post-Chikungunya Arthritis: An Observational Study at a Tertiary PMR Clinic in Chattogram, Bangladesh

Open Access

Abstract

Introduction: Chikungunya virus infection is a mosquito-borne illness characterized by fever, rash, and debilitating joint pain. While acute symptoms typically resolve within days, many patients develop post-chikungunya musculoskeletal manifestations, including arthralgia, arthritis, and functional impairment. Understanding the patterns of musculoskeletal involvement and associated disability is essential for effective management and rehabilitation. This study aimed to evaluate the musculoskeletal manifestations of post-chikungunya arthritis among patients attending the Physical Medicine & Rehabilitation outpatient department at Marine City Medical College Hospital, Chattogram, Bangladesh. Methods & Materials: This prospective observational study evaluated 265 patients presenting with persistent musculoskeletal symptoms following chikungunya infection. Demographic data, joint involvement patterns (polyarticular vs. oligoarticular, symmetrical vs. asymmetrical), and peri-articular manifestations were recorded. Functional disability was assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI). Results: Among the 265 participants, a female predominance was observed 165 (62.3%), with the highest prevalence in the 40–49 years age group 85 (32.1%). The most frequently involved joints were the small joints of the hands 212 (80%), followed by the ankle 207 (78.1%), knee 199 (75.1%), and foot 191 (72.1%). Clinical patterns were predominantly polyarticular 225 (84.9%) and symmetrical 186(70.2%). Significant peri-articular involvement was noted, including tenosynovitis (44.9%), bursitis (35.1%), and tendinitis (27.9%). Functional limitation was moderate to severe in 186 (70.2%) patients, showing a positive correlation with the number of involved joints. Conclusion: Post-chikungunya arthritis predominantly affects small peripheral joints in a symmetrical polyarticular pattern, leading to substantial functional limitation. Early recognition and targeted rehabilitation can significantly improve outcomes and quality of life.