Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/19522 |
Resumo: | Chikungunya fever (CF) is an arboviral disease transmitted by Aedes mosquitoes infected with the Chikungunya virus (VCHIK). It is an epidemic in several countries around the world. The disease causes chronic and disabling arthritis for up to five years after infection and affects many of the economically active population. Study one describes, through clinical, laboratory, ultrasound (US), and magnetic resonance (MRI) data, how a 49- year-old man developed psoriatic arthritis (PA) after CF infection. The clinical picture of classic synovitis and tenosynovitis secondary to CF, the persistence of inflammatory disease with signs of enthesitis and dactylitis on US and MRI, positive family history, and the appearance of skin lesions on the scalp strongly suggested post-CF PA, according to the criteria of the American College of Rheumatology. Study two aimed to analyze the musculoskeletal changes in the wrists and hands through physical examination (PE), US, and MRI. Thirty patients with a proven laboratory diagnosis of CF were evaluated in the chronic phase of the disease. There was a predominance of females, and the average age was 54.7 years. The analyzed sites were the interphalangeal (IF), metacarpophalangeal (MCF), and wrist/midcarpal joints. The interval between PE and imaging exams was seven days, and the interval between US and MRI was at most two days. The kappa coefficient was calculated to estimate the agreement between the PE, US, and MR findings. A significant agreement was observed between PE and US in diagnosing synovitis. The only statistically significant (moderate agreement) between US and MRI was the finding of flexor tenosynovitis. US has potential for diagnostic confirmation of suspected synovitis based on positivity of the PE. The limited agreement between US and MRI for other findings, in turn, may suggest a complementary role for these methods. |
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Mogami, Robertohttp://lattes.cnpq.br/4300866819252154Sztajnbok, Flávio Robertohttp://lattes.cnpq.br/4277113603642992Lopes, Agnaldo Joséhttp://lattes.cnpq.br/1548788734980219Koifman, Ana Célia Baptistahttp://lattes.cnpq.br/5787376872479808Pinheiro, Geraldo da Rocha Castelarhttp://lattes.cnpq.br/7536115815141738Martins e Souza, Patríciahttp://lattes.cnpq.br/6629970038061223Abreu, Mirhelen Mendes dehttp://lattes.cnpq.br/7242246597159087http://lattes.cnpq.br/7091946696457852Leidersnaider, Caio Lealcaiofmp@gmail.com2023-05-08T13:16:12Z2021-12-10LEIDERSNAIDER, Caio Leal. Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica. 2021. 99 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021.http://www.bdtd.uerj.br/handle/1/19522Chikungunya fever (CF) is an arboviral disease transmitted by Aedes mosquitoes infected with the Chikungunya virus (VCHIK). It is an epidemic in several countries around the world. The disease causes chronic and disabling arthritis for up to five years after infection and affects many of the economically active population. Study one describes, through clinical, laboratory, ultrasound (US), and magnetic resonance (MRI) data, how a 49- year-old man developed psoriatic arthritis (PA) after CF infection. The clinical picture of classic synovitis and tenosynovitis secondary to CF, the persistence of inflammatory disease with signs of enthesitis and dactylitis on US and MRI, positive family history, and the appearance of skin lesions on the scalp strongly suggested post-CF PA, according to the criteria of the American College of Rheumatology. Study two aimed to analyze the musculoskeletal changes in the wrists and hands through physical examination (PE), US, and MRI. Thirty patients with a proven laboratory diagnosis of CF were evaluated in the chronic phase of the disease. There was a predominance of females, and the average age was 54.7 years. The analyzed sites were the interphalangeal (IF), metacarpophalangeal (MCF), and wrist/midcarpal joints. The interval between PE and imaging exams was seven days, and the interval between US and MRI was at most two days. The kappa coefficient was calculated to estimate the agreement between the PE, US, and MR findings. A significant agreement was observed between PE and US in diagnosing synovitis. The only statistically significant (moderate agreement) between US and MRI was the finding of flexor tenosynovitis. US has potential for diagnostic confirmation of suspected synovitis based on positivity of the PE. The limited agreement between US and MRI for other findings, in turn, may suggest a complementary role for these methods.A febre Chikungunya (FC) é uma doença arboviral transmitida por mosquitos Aedes infectados pelo vírus Chikungunya (VCHIK). Ela é epidêmica em vários países ao redor do mundo. A doença causa artrite crônica e incapacitante por até cinco anos após a infecção, e atinge grande parte da população economicamente ativa. O estudo um descreve, por meio de dados clínicos, laboratoriais, ultrassonográficos (US) e de ressonância magnética (RM) como um homem de 49 anos desenvolveu artrite psoriásica (AP) após infecção pela FC. O quadro de sinovite e tenossinovite clássicas secundárias à FC, a persistência de doença inflamatória com sinais de entesite e dactilite na US e RM, a história familiar positiva e o aparecimento de lesões cutâneas no couro cabeludo sugere fortemente AP pós-FC, segundo os critérios do Colégio Americano de Reumatologia. O estudo dois teve como objetivo analisar as alterações musculoesqueléticas de punhos e mãos por meio do exame físico (EF), US e RM. Trinta pacientes com diagnóstico laboratorial comprovado de FC foram avaliados na fase crônica da doença. Houve predominância do sexo feminino e a média da idade foi de 54,7 anos. Os locais analisados foram as regiões interfalângica (IF), metacarpofalângica (MCF) e articulações do punho/mediocarpal (PMC). O intervalo entre o EF e os exames de imagens foi de sete dias, e o intervalo entre a US e RM foi de no máximo dois dias. O coeficiente kappa foi calculado para estimar a concordância entre os achados de EF, US e RM. Foi observada concordância significativa entre EF e US no diagnóstico de sinovites. A única concordância estatisticamente significativa (grau moderado) entre US e RM foi o achado de tenossinovite flexora. A US tem potencial para confirmação diagnóstica na suspeita de sinovite, com base na uma positividade do EF. A limitada concordância entre US e RM para outros achados, por sua vez, pode sugerir um papel complementar destes métodos.Submitted by Heloísa CB/A (helobdtd@gmail.com) on 2023-05-08T13:16:12Z No. of bitstreams: 1 Tese - Caio Leal Leidersnaider - Completa - 2021.pdf: 3641978 bytes, checksum: 9d3dd0d68c197c51ecd5f1b577dc43d5 (MD5)Made available in DSpace on 2023-05-08T13:16:12Z (GMT). No. of bitstreams: 1 Tese - Caio Leal Leidersnaider - Completa - 2021.pdf: 3641978 bytes, checksum: 9d3dd0d68c197c51ecd5f1b577dc43d5 (MD5) Previous issue date: 2021-12-10application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Ciências MédicasUERJBrasilCentro Biomédico::Faculdade de Ciências MédicasChikungunya feverPhysical examationUltrasoundMagnetic resonance imagingMusculoskeletalFebre ChikungunyaExame físicoUltrassonografiaRessonância magnéticaMusculoesqueléticoCIENCIAS DA SAUDE::MEDICINA::RADIOLOGIA MEDICAAnálise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônicaComparative analysis between physical examination, ultrasound, and magnetic resonance imaging of the wrists and hands in the study of clinical musculoskeletal manifestations of chronic Chikungunya feverinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Caio Leal Leidersnaider - 2021 - Completa.pdfTese - Caio Leal Leidersnaider - 2021 - Completa.pdfapplication/pdf3641978http://www.bdtd.uerj.br/bitstream/1/19522/2/Tese+-+Caio+Leal+Leidersnaider+-+2021+-+Completa.pdf9d3dd0d68c197c51ecd5f1b577dc43d5MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/19522/1/license.txte5502652da718045d7fcd832b79fca29MD511/195222024-02-26 15:59:52.397oai:www.bdtd.uerj.br:1/19522Tk9UQTogTElDRU7Dh0EgUkVERSBTSVJJVVMKRXN0YSBsaWNlbsOnYSBkZSBleGVtcGxvIMOpIGZvcm5lY2lkYSBhcGVuYXMgcGFyYSBmaW5zIGluZm9ybWF0aXZvcy4KCkxJQ0VOw4dBIERFIERJU1RSSUJVScOHw4NPIE7Dg08tRVhDTFVTSVZBCgpDb20gYSBhcHJlc2VudGHDp8OjbyBkZXN0YSBsaWNlbsOnYSwgdm9jw6ogKG8gYXV0b3IgKGVzKSBvdSBvIHRpdHVsYXIgZG9zIGRpcmVpdG9zIGRlIGF1dG9yKSBjb25jZWRlIMOgIFVuaXZlcnNpZGFkZSAKZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBvIGRpcmVpdG8gbsOjby1leGNsdXNpdm8gZGUgcmVwcm9kdXppciwgIHRyYWR1emlyIChjb25mb3JtZSBkZWZpbmlkbyBhYmFpeG8pLCBlL291IApkaXN0cmlidWlyIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAoaW5jbHVpbmRvIG8gcmVzdW1vKSBwb3IgdG9kbyBvIG11bmRvIG5vIGZvcm1hdG8gaW1wcmVzc28gZSBlbGV0csO0bmljbyBlIAplbSBxdWFscXVlciBtZWlvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mgw6F1ZGlvIG91IHbDrWRlby4KClZvY8OqIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250ZcO6ZG8sIHRyYW5zcG9yIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAKcGFyYSBxdWFscXVlciBtZWlvIG91IGZvcm1hdG8gcGFyYSBmaW5zIGRlIHByZXNlcnZhw6fDo28uCgpWb2PDqiB0YW1iw6ltIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSBtYW50ZXIgbWFpcyBkZSB1bWEgY8OzcGlhIGEgc3VhIHRlc2Ugb3UgCmRpc3NlcnRhw6fDo28gcGFyYSBmaW5zIGRlIHNlZ3VyYW7Dp2EsIGJhY2stdXAgZSBwcmVzZXJ2YcOnw6NvLgoKVm9jw6ogZGVjbGFyYSBxdWUgYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIMOpIG9yaWdpbmFsIGUgcXVlIHZvY8OqIHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIApuZXN0YSBsaWNlbsOnYS4gVm9jw6ogdGFtYsOpbSBkZWNsYXJhIHF1ZSBvIGRlcMOzc2l0byBkYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIG7Do28sIHF1ZSBzZWphIGRlIHNldSAKY29uaGVjaW1lbnRvLCBpbmZyaW5nZSBkaXJlaXRvcyBhdXRvcmFpcyBkZSBuaW5ndcOpbS4KCkNhc28gYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIGNvbnRlbmhhIG1hdGVyaWFsIHF1ZSB2b2PDqiBuw6NvIHBvc3N1aSBhIHRpdHVsYXJpZGFkZSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMsIHZvY8OqIApkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgw6AgVUVSSiBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgCmlkZW50aWZpY2FkbyBlIHJlY29uaGVjaWRvIG5vIHRleHRvIG91IG5vIGNvbnRlw7pkbyBkYSB0ZXNlIG91IGRpc3NlcnRhw6fDo28gb3JhIGRlcG9zaXRhZGEuCgpDQVNPIEEgVEVTRSBPVSBESVNTRVJUQcOHw4NPIE9SQSBERVBPU0lUQURBIFRFTkhBIFNJRE8gUkVTVUxUQURPIERFIFVNIFBBVFJPQ8ONTklPIE9VIApBUE9JTyBERSBVTUEgQUfDik5DSUEgREUgRk9NRU5UTyBPVSBPVVRSTyBPUkdBTklTTU8gUVVFIE7Dg08gU0VKQSBFU1RBClVOSVZFUlNJREFERSwgVk9Dw4ogREVDTEFSQSBRVUUgUkVTUEVJVE9VIFRPRE9TIEUgUVVBSVNRVUVSIERJUkVJVE9TIERFIFJFVklTw4NPIENPTU8gClRBTULDiU0gQVMgREVNQUlTIE9CUklHQcOHw5VFUyBFWElHSURBUyBQT1IgQ09OVFJBVE8gT1UgQUNPUkRPLgoKQSBVbml2ZXJzaWRhZGUgZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lIChzKSBvdSBvKHMpIG5vbWUocykgZG8ocykgCmRldGVudG9yKGVzKSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMgZGEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvLCBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIGFsw6ltIGRhcXVlbGFzIApjb25jZWRpZGFzIHBvciBlc3RhIGxpY2Vuw6dhLgo=Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T18:59:52Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica |
dc.title.alternative.eng.fl_str_mv |
Comparative analysis between physical examination, ultrasound, and magnetic resonance imaging of the wrists and hands in the study of clinical musculoskeletal manifestations of chronic Chikungunya fever |
title |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica |
spellingShingle |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica Leidersnaider, Caio Leal Chikungunya fever Physical examation Ultrasound Magnetic resonance imaging Musculoskeletal Febre Chikungunya Exame físico Ultrassonografia Ressonância magnética Musculoesquelético CIENCIAS DA SAUDE::MEDICINA::RADIOLOGIA MEDICA |
title_short |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica |
title_full |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica |
title_fullStr |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica |
title_full_unstemmed |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica |
title_sort |
Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica |
author |
Leidersnaider, Caio Leal |
author_facet |
Leidersnaider, Caio Leal caiofmp@gmail.com |
author_role |
author |
author2 |
caiofmp@gmail.com |
author2_role |
author |
dc.contributor.advisor1.fl_str_mv |
Mogami, Roberto |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4300866819252154 |
dc.contributor.advisor-co1.fl_str_mv |
Sztajnbok, Flávio Roberto |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/4277113603642992 |
dc.contributor.referee1.fl_str_mv |
Lopes, Agnaldo José |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/1548788734980219 |
dc.contributor.referee2.fl_str_mv |
Koifman, Ana Célia Baptista |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/5787376872479808 |
dc.contributor.referee3.fl_str_mv |
Pinheiro, Geraldo da Rocha Castelar |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/7536115815141738 |
dc.contributor.referee4.fl_str_mv |
Martins e Souza, Patrícia |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/6629970038061223 |
dc.contributor.referee5.fl_str_mv |
Abreu, Mirhelen Mendes de |
dc.contributor.referee5Lattes.fl_str_mv |
http://lattes.cnpq.br/7242246597159087 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/7091946696457852 |
dc.contributor.author.fl_str_mv |
Leidersnaider, Caio Leal caiofmp@gmail.com |
contributor_str_mv |
Mogami, Roberto Sztajnbok, Flávio Roberto Lopes, Agnaldo José Koifman, Ana Célia Baptista Pinheiro, Geraldo da Rocha Castelar Martins e Souza, Patrícia Abreu, Mirhelen Mendes de |
dc.subject.eng.fl_str_mv |
Chikungunya fever Physical examation Ultrasound Magnetic resonance imaging Musculoskeletal |
topic |
Chikungunya fever Physical examation Ultrasound Magnetic resonance imaging Musculoskeletal Febre Chikungunya Exame físico Ultrassonografia Ressonância magnética Musculoesquelético CIENCIAS DA SAUDE::MEDICINA::RADIOLOGIA MEDICA |
dc.subject.por.fl_str_mv |
Febre Chikungunya Exame físico Ultrassonografia Ressonância magnética Musculoesquelético |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA::RADIOLOGIA MEDICA |
description |
Chikungunya fever (CF) is an arboviral disease transmitted by Aedes mosquitoes infected with the Chikungunya virus (VCHIK). It is an epidemic in several countries around the world. The disease causes chronic and disabling arthritis for up to five years after infection and affects many of the economically active population. Study one describes, through clinical, laboratory, ultrasound (US), and magnetic resonance (MRI) data, how a 49- year-old man developed psoriatic arthritis (PA) after CF infection. The clinical picture of classic synovitis and tenosynovitis secondary to CF, the persistence of inflammatory disease with signs of enthesitis and dactylitis on US and MRI, positive family history, and the appearance of skin lesions on the scalp strongly suggested post-CF PA, according to the criteria of the American College of Rheumatology. Study two aimed to analyze the musculoskeletal changes in the wrists and hands through physical examination (PE), US, and MRI. Thirty patients with a proven laboratory diagnosis of CF were evaluated in the chronic phase of the disease. There was a predominance of females, and the average age was 54.7 years. The analyzed sites were the interphalangeal (IF), metacarpophalangeal (MCF), and wrist/midcarpal joints. The interval between PE and imaging exams was seven days, and the interval between US and MRI was at most two days. The kappa coefficient was calculated to estimate the agreement between the PE, US, and MR findings. A significant agreement was observed between PE and US in diagnosing synovitis. The only statistically significant (moderate agreement) between US and MRI was the finding of flexor tenosynovitis. US has potential for diagnostic confirmation of suspected synovitis based on positivity of the PE. The limited agreement between US and MRI for other findings, in turn, may suggest a complementary role for these methods. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021-12-10 |
dc.date.accessioned.fl_str_mv |
2023-05-08T13:16:12Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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dc.identifier.citation.fl_str_mv |
LEIDERSNAIDER, Caio Leal. Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica. 2021. 99 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/19522 |
identifier_str_mv |
LEIDERSNAIDER, Caio Leal. Análise comparativa entre exame físico, ultrassonografia e ressonância magnética nos punhos e mãos no estudo das manifestações clínicas musculoesqueléticas da febre Chikungunya crônica. 2021. 99 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021. |
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http://www.bdtd.uerj.br/handle/1/19522 |
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por |
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Universidade do Estado do Rio de Janeiro |
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UERJ |
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Brasil |
dc.publisher.department.fl_str_mv |
Centro Biomédico::Faculdade de Ciências Médicas |
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Universidade do Estado do Rio de Janeiro |
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