title: Polyarthritis in four patients with chikungunya arthritis.
abstract: The incidence of chikungunya infection in Singapore has been on the rise since the first reported case in 2006. Acute polyarthritis, a common manifestation among affected patients, may precede fever and present with debilitating arthritis to rheumatologists, orthopaedists, internists and primary care physicians. The diagnosis of chikungunya infection requires careful history taking and a high index of suspicion, with supporting evidence from the reverse transcription-polymerase chain reaction or the chikungunya IgM serology test. Treatment of chikungunya arthritis usually involves non-steroidal anti-inflammatory drugs. Rarely, polyarthritis in chikungunya may persist even after resolution of the acute infection, necessitating treatment with disease-modifying anti-rheumatic drugs. In this article, we present the different manifestations of chikungunya arthritis in our local setting and review the literature.
authors.affiliation: Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore 169608. lui.nai.lee@sgh.com.sg
authors.forename: Nai Lee
authors.initials: NL
authors.lastname: Lui
authors.forename: Hoe Nam
authors.initials: HN
authors.lastname: Leong
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
mesh_terms: D000368:Aged; D018354:Alphavirus Infections / Q000150:complications*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy* / Q000821:virology; D065632:Chikungunya Fever; D002646:Chikungunya virus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal