Contents
- How does viral arthritis develop?
- What are the symptoms of viral arthritis?
- The causes of viral arthritis
- Parvovirus B19
- Rubella virus
- Hepatitis B and C viruses
- HIV (human immunodeficiency virus)
- HTLV (human T-cell derived leukemia virus)
- EBV (wirus Epsteina- Barr)
- Diagnosis of viral arthritis
- Treatment of viral arthritis
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Viral Arthritis – As the name suggests, this is a disease associated with the presence of viruses inside the joints. It is less common than bacterial inflammation, but it is just as unpleasant.
Viral arthritis can become active after infection with human parvovirus B19, rubella virus (mainly women), mumps (mainly men), HIV, hepatitis B and C viruses. Arthritis is a disease less common than bacterial arthritis, but just as unpleasant. for the sick. When the viruses penetrate the joint, inflammation develops and the characteristic symptoms appear.
Viruses can provoke inflammation in your joints in two ways:
1. They can attack the synovium of the joint, causing the destruction of its cells and the development of inflammation, or lead to the formation of immune complexes in the joints that promote the development of inflammation. This type of arthritis can affect both large and small joints.
2. They can affect individual joints, as in the case of HIV infection, when the knee joint is usually inflamed. More often, however, viral arthritis is symmetrical and multi-condition. They usually last a short time and rarely turn into chronic inflammations, which result in erosions and osteomyelitis with its fibrosis.
Viral arthritis begins suddenly as symmetrical inflammations of the small joints, especially the hands and feet. Symptoms in small joints begin a few days after being infected with the virus, but the knee, ankle, shoulder and elbow joints can also be affected.
Arthritis caused by rubella virus usually disappears quickly, but can sometimes go on for up to a year after infection. In the case of hepatitis B infection, joint problems persist for 1-3 weeks. Characteristically, they disappear as soon as jaundice appears. then regress with the onset of jaundice.
People infected with HIV develop pain or inflammation of a single joint (very often it is the knee joint). There are also features of dryness syndrome, reactive or psoriatic arthritis.
The main clinical symptoms of joint diseases are pain and swelling, and limited mobility. In addition, the skin around the joint is red.
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There are many causes of viral arthritis. We have already listed most of the arthritis-provoking viruses. But there is also a group of viruses that we deal with less frequently and that can also cause viral arthritis. Belong to them:
- pox virus, HTLV (human T-cell leukemia virus)
- a virus that causes common polyarthritis,
- a virus endemic to Scandinavia – Sindbis virus),
- endemic viruses (chikunguanya virus, igbo-ara virus, Onyong-nyong, Maya, EBV virus (Epstein-Barr virus).
Viruses that are endemic are usually those that cause rash and fever, coupled with multi-condition inflammation. Let’s get to know them a bit closer.
Parvovirus B19
It causes the characteristic blotchy erythematous rash on the face and torso. It is accompanied by polyarthritis, a stiffness in the joints that annoys mainly after getting out of bed after a night’s rest. Usually the inflammation lasts up to 14 days. It rarely turns into a chronic form, which is manifested by the destruction of the joints. chronic inflammation may develop, with joint destruction. The virus takes 1 to 2 weeks to manifest itself (this is the incubation time), which may be accompanied by fever, sore throat, lack of appetite and dyspeptic symptoms.
Rubella virus
Infection with the rubella virus leads to enlargement of the lymph nodes. Infection is confirmed by fever, rash and joint pain which usually lasts for about 10 days. Pain may also affect the shoulder joints, hands and the lumbar spine. Virus incubation takes 2 to 3 weeks. Arthritis can happen after rubella vaccination.
Hepatitis B and C viruses
In hepatitis B (HBV), the inflammation is polyarticular. They are characterized by joint stiffness which disappears after the appearance of jaundice. Laboratory tests show the presence of HBsAg, HBeAg or anti-HBcAg in the blood. The symptoms of infection are also hives, inflammation in the peripheral joints, general breakdown, headache, nausea and vomiting, as well as muscle pain. Polyarteritis nodosa may be a serious complication.
Hepatitis C and HCV also provoke polyarthritis. A complication may be cryoglobulinemia, i.e. the presence of pathological proteins in the plasma.
HIV (human immunodeficiency virus)
The HIV picture of arthritis is ambiguous. It must be differentiated from psoriatic arthritis, Sjögren’s syndrome and pathologies affecting the joints of the spine. HIV very often affects one joint and the most common is the knee joint. The synovial fluid shows high pleocytosis, that is, the presence of a large number of cells of a given type, in this case HIV.
HTLV (human T-cell derived leukemia virus)
Inflammation occurs in a few joints. Leukemia cells are sometimes found in tests. Besides, a lumpy rash appears.
EBV (wirus Epsteina- Barr)
EBV can cause joint pain, but without the accompanying inflammation.
The diagnosis of viral arthritis is made after careful history and symptom assessment. The physician must take into account the presence of other viral and latent diseases, joint injuries, and the use of drugs.
They are helpful in making a diagnosis imaging tests – ultrasound, x-rays and bone scintigraphy or computed tomography. Magnetic resonance imaging can show edema changes in the soft tissues and joints, and also confirm the coexistence of osteomyelitis.
In viral arthritis, it is difficult to detect the presence of the virus in the synovial fluid. This makes a correct diagnosis much more difficult.
Treatment of viral arthritis consists of controlling symptoms, administering antipyretic and anti-inflammatory drugs, as most of these types of inflammation go away on their own after the body fights off the virus responsible for the infection and develops inflammation. People with viral arthritis are not given antibiotics because they are not effective for this type of infection. It is advisable to start the pond early to ensure proper nutrition and hydration. Light exercise also protects against the formation of fibrous adhesions within the joint.
The joints can also be lubricated with warming and analgesic preparations. We recommend, for example, Cryossil AZ – regenerating gel around the joints, which soothes swelling and is quickly absorbed.
If you are infected with HIV, you can take: sulfasalazine and antimalarials such as hydroxychloroquine. In complications in the form of polyarteritis nodosa and cryoglobulinemia, interferon and immunosuppressants are administered.
Tekst: Anna Jarosz