Muscle soreness and achy joints are frequent signs amongst COVID-19 sufferers. However for some folks, signs are extra extreme, lengthy lasting and even weird, together with rheumatoid arthritis flares, autoimmune myositis or “COVID toes.”
A brand new Northwestern Drugs research has, for the primary time, confirmed and illustrated the causes of those signs by means of radiological imaging.
“We have realized that the COVID virus can set off the physique to assault itself in several methods, which can result in rheumatological points that require lifelong administration,” mentioned corresponding creator Dr. Swati Deshmukh.
The paper will likely be revealed Feb. 17 within the journal Skeletal Radiology. The research is a retrospective overview of information from sufferers who introduced to Northwestern Memorial Hospital between Could 2020 and December 2020.
“Many sufferers with COVID-related musculoskeletal problems get better, however for some people, their signs turn out to be critical, are deeply regarding to the affected person or impression their high quality of life, which leads them to hunt medical consideration and imaging,” mentioned Deshmukh, an assistant professor of musculoskeletal radiology at Northwestern College Feinberg Faculty of Drugs and a Northwestern Drugs musculoskeletal radiologist. “That imaging permits us to see if COVID-related muscle and joint ache, for instance, usually are not simply physique aches just like what we see from the flu — however one thing extra insidious.”
Imaging (CT, MRI, ultrasound) will help clarify why somebody might need extended musculoskeletal signs after COVID, directing them to hunt the precise doctor for remedy, akin to a rheumatologist or dermatologist.
In some instances, radiologists might even counsel a COVID analysis based mostly on musculoskeletal imaging in sufferers who beforehand did not know they contracted the virus, Deshmukh mentioned.
What does the imaging appear like?
“We’d see edema and inflammatory adjustments of the tissues (fluid, swelling), hematomas (collections of blood) or devitalized tissue (gangrene),” Deshmukh mentioned. “In some sufferers, the nerves are injured (vivid, enlarged) and in others, the issue is impaired blood move (clots).”
How can imaging result in higher remedy?
“I feel it is essential to distinguish between what the virus causes instantly and what it triggers the physique to do,” Deshmukh mentioned. “It is essential for medical doctors to know what’s taking place so as to deal with appropriately.”
For instance, Deshmukh mentioned, if a affected person has persistent shoulder ache that began after contracting COVID, their main care supplier would possibly order an MRI/ultrasound. If a radiologist is aware of COVID can set off inflammatory arthritis and imaging exhibits joint irritation, then they will ship a affected person to a rheumatologist for analysis.
“Some medical doctors request imaging for sufferers with ‘COVID toes,’ for instance, however there wasn’t any literature on imaging of foot and smooth tissue issues of COVID,” Deshmukh mentioned. “How do you discover one thing if you happen to’re not sure of what to search for? So in our paper, we talk about the varied forms of musculoskeletal abnormalities that radiologists ought to search for and supply imaging examples.”
Different Northwestern authors on the paper have been Santhoshini Leela Ramani (Northwestern College medical pupil), Dr. Jonathan Samet (radiology), Dr. Colin Franz (PMR and neurology), Dr. Christine Hsieh (rheumatology), Dr Cuong Nguyen (dermatology) and Dr. Craig Horbinski (pathology).