Stiffness, pain, and joint counts in chronic chikungunya disease: relevance to disability and quality of life

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Hugh Watson
  • Sarah R. Tritsch, George Washington University
  • ,
  • Liliana Encinales, Allied Research Society
  • ,
  • Andres Cadena, Clinica de La Costa Ltda
  • ,
  • Carlos Cure, Biomelab
  • ,
  • Alexandra Porras Ramirez, Universidad El Bosque
  • ,
  • Alejandro Rico Mendoza, Universidad El Bosque
  • ,
  • Aileen Y. Chang, George Washington University

Introduction/Objectives: To characterize the importance of musculoskeletal stiffness in a cohort of chikungunya patients with chronic joint symptoms. Method: Eighty-two patients were followed up 3 years after chikungunya infection. Tender and swollen joint counts, a pain intensity scale, Health Assessment Questionnaire-Disability Index (HAQ-DI), and the EuroQol EQ-5D quality of life instrument were completed. A musculoskeletal stiffness questionnaire provided scores for overall stiffness and its components: stiffness severity, physical impact, and psychosocial impact. Results: Patients had a mean age 51 ± 14 years. Sixty-seven patients were still experiencing chronic arthralgia. Musculoskeletal stiffness was reported by 43/67 patients with arthralgia and 3/15 patients without arthralgia. A physical impact of stiffness was reported by 87% patients and psychosocial impact by 71% patients. Mean tender joint count in patients reporting arthralgia was 6 ± 7, mean pain intensity 65 ± 20 out of 100, mean HAQ-DI was 0.54 ± 0.52, and mean EQ-VAS global health perception was 68 ± 62 out of 100. Stiffness severity was correlated with tender joint counts (ρ = 0.46) and pain intensity (ρ = 0.40). All three measures were equally well correlated with the EuroQol-VAS global health perception. Pain and tender joints were better correlated with the HAQ-DI (ρ = 0.68 and ρ = 0.63), but stiffness was more strongly correlated with several quality of life domains, including mobility. Swollen joints were a poor predictor of outcomes. Conclusions: Musculoskeletal stiffness following chikungunya infection is distinct from arthralgia. It does not always occur in the same patients or with a corresponding intensity. Joint pain and stiffness may be independently associated with disability and quality of life assessments.

Original languageEnglish
JournalClinical Rheumatology
Pages (from-to)1679-1686
Number of pages8
Publication statusPublished - May 2020

    Research areas

  • Activities of daily living, Health assessment questionnaire, Outcomes

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