{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:07:22Z","timestamp":1777298842465,"version":"3.51.4"},"reference-count":28,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,5]]},"abstract":"<jats:p>Chikungunya virus (CHIKV) causes an acute febrile illness usually accompanied by severe polyarthralgia and polyarthritis. Previous studies have shown that older age, female gender, and some comorbid conditions are associated with chronic CHIKV arthritis. However, the factors associated with acute arthralgia and arthritis are not well known. Thus, we studied the clinical manifestations associated with acute peripheral joint involvement in a group of CHIKV patients from Puerto Rico. Patients with a history of fever for &lt; 7 days evaluated at the emergency department of a university-based hospital were tested for several pathogens including CHIKV. All patients with laboratory-positive CHIKV infection were studied. Demographic features, clinical manifestations, and comorbidities were determined. Patients with and without peripheral joint involvement were compared using bivariable and multivariable analyses. In total, 172 patients with CHIKV fever were evaluated; 52.9% were women. The mean (standard deviation) age was 21.1 years (19.3). Peripheral arthralgia and\/or arthritis were seen in 156 (90.7%) patients. In the multivariable analysis adjusted for age and gender, peripheral joint involvement was associated with myalgia (odds ratio [OR] = 4.65, 95% confidence interval [CI] = 1.48\u201314.72), back pain (OR = 16.77, 95% CI = 3.07\u2013313.82), ocular pain (OR = 8.88, 95% CI = 1.65\u2013165.19), headache (OR = 3.63, 95% CI = 1.06\u201312.53), anorexia (OR = 5.68, 95% CI = 1.87\u201318.97), and nausea (OR = 6.88, 95% CI = 2.05\u201331.49). In conclusion, in this population of patients with acute CHIKV infection, peripheral joint involvement was associated with myalgia and back pain as well as nonmusculoskeletal manifestations such as headache, ocular pain, anorexia, and nausea.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0890","type":"journal-article","created":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T03:00:48Z","timestamp":1485831648000},"page":"916-921","source":"Crossref","is-referenced-by-count":9,"title":["Clinical Manifestations Associated with Peripheral Joint Involvement in Patients with Acute Chikungunya Virus Infection"],"prefix":"10.4269","volume":"96","author":[{"given":"Mariangel\u00ed","family":"Arroyo-\u00c1vila","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Cab\u00e1n","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enid J.","family":"Garc\u00eda-Rivera","sequence":"additional","affiliation":[{"name":"Endowed Health Services Research Center, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisela","family":"Irizarry-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Endowed Health Services Research Center, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilda","family":"Torres","sequence":"additional","affiliation":[{"name":"Endowed Health Services Research Center, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9ctor","family":"Gorbea","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis M.","family":"Vil\u00e1","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Clin Infect Dis","first-page":"942","article-title":"Chikungunya fever: an epidemiological review of a re-emerging infectious disease","volume":"49","author":"Staples","year":"2009"},{"key":"ref2","series-title":"P R Health Sci J","first-page":"71","article-title":"Rheumatic manifestations in patients with chikungunya infection","volume":"34","author":"Arroyo-\u00c1vila","year":"2015"},{"key":"ref3","series-title":"Chikungunya Virus: Geographic Distribution","author":"Centers for Disease Control and Prevention Website","year":"2016"},{"key":"ref4","series-title":"Epidemiol Infect","first-page":"534","article-title":"Atypical chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005\u20132006 outbreak on R\u00e9union","volume":"137","author":"Economopoulou","year":"2009"},{"key":"ref5","series-title":"Lancet","first-page":"514","article-title":"Chikungunya in the Americas","volume":"383","author":"Leparc-Goffart","year":"2014"},{"key":"ref6","series-title":"Clin Infect Dis","first-page":"1401","article-title":"Outbreak of chikungunya on Reunion Island: early clinical and laboratory features in 157 adult patients","volume":"44","author":"Borgherini","year":"2007"},{"key":"ref7","series-title":"Epidemiol Infect","first-page":"842","article-title":"Acute chikungunya and persistent musculoskeletal pain following the 2006 Indian epidemic: a 2-year prospective rural community study","volume":"140","author":"Chopra","year":"2012"},{"key":"ref8","series-title":"J Clin Virol","first-page":"111","article-title":"Chikungunya fever in Singapore: acute clinical and laboratory features, and factors associated with persistent arthralgia","volume":"49","author":"Win","year":"2010"},{"key":"ref9","series-title":"Trans R Soc Trop Med Hyg","first-page":"392","article-title":"Clinical progression of chikungunya fever during acute and chronic arthritic stages and the changes in joint morphology as revealed by imaging","volume":"104","author":"Manimunda","year":"2010"},{"key":"ref10","series-title":"Medicine","first-page":"123","article-title":"Chikungunya infection: an emerging rheumatism among travelers returned from Indian Ocean islands. 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