Joint Immobility and Viral Infections: Causes, Diagnosis, and Treatment

Introduction

Arthritis means inflammation or swelling in one or more joints. Arthritis usually causes stiffness and immobility in the joints. Polyarthritis is an acute form of virus-induced arthritis. The viruses most commonly involved are parvovirus, alphavirus, hepatitis B, hepatitis C, Epstein-Barr virus, and tropical viruses such as Zika virus and Chikungunya virus. A diagnosis of viral arthritis should be considered in all patients with acute-onset polyarticular manifestations. Although viruses cause only a small fraction of cases of acute arthritis, the distinction between viral-mediated arthritis and primary rheumatic disease is important as it affects subsequent management. Joint damage is rare if virus infection-induced arthritis is recognized and treated promptly. However, many types of infections can damage joints, especially if viral infections are not diagnosed and treated in time.

What Is Joint Immobility Induced by Viral Infections?

Viral infections often cause an inflammatory syndrome in which joint pain or arthritis can be the dominant manifestation. Most cases of joint stiffness, such as rubella and parvovirus B19 arthritis, are short-lived and self-limiting due to the efficient elimination of the organism by the immune system. Chronic joint inflammation is associated with immunodeficiency leading to persistent or latent viral infections, virus-induced autoimmunity, polyclonal B-cell activation, and opportunistic infections, mainly due to the inability of the immune system to eliminate pathogens. Viruses in this latter group include human immunodeficiency virus 1 (HIV-1), human lymphotropic T-cell virus type I (HTLV-I), and hepatitis C virus (HCV). SARS-CoV-2 is recognized as a potential trigger of inflammatory arthritis, which may further lead to immobility, not only in patients with inflammatory rheumatic disease but also in previously unaffected patients. There is either a direct invasion of the virus in the joint cells or an immune reaction of the body which can potentially alter the joint health.

What Are the Causes of Joint Immobility Induced by Viral Infections?

Virus-induced joint immobility may be caused due to infection with any of the following viruses:

• Alphaviruses (chikungunya virus).

• Coronavirus (COVID-19).

• Flaviviruses (dengue fever and Zika virus).

• Hepatitis B.

• Hepatitis C.

• Herpes simplex virus.

• HIV.

• Epstein-Barr virus (the virus that causes mononucleosis).

• Mumps.

• Parvovirus.

• Rubella.

What Are the Risk Factors of Joint Immobility Induced by Viral Infections?

The risk factors of virus-induced joint immobility include:

• People who use needles to inject illegal drugs.

• People who do not have access to clean drinking water.

• People who are not vaccinated.

• People who do not practice safe sex.

• People who are prone to mosquito bites.

• People who stay in an area where the prevalence of certain viruses is common.

What Are the Symptoms of a Joint Immobility Induced by Viral Infections?

The symptoms of virus-induced joint immobility vary depending on the type of viral infection present. Symptoms can include:

• Fever.

• Pink eye (conjunctivitis).

• Rash.

• Joint pain (arthralgia).

• Joint immobility.

• Swollen lymph nodes.

When to Get Help for Joint Immobility Induced by Viral Infections?

A person should seek immediate medical assistance in case of the following signs and symptoms:

• High fever.

• Rash.

• Vomiting.

• Nausea.

• Diarrhea.

• Inability to breathe.

• Inability to walk due to joint immobility.

How Are Joint Immobility Induced by Viral Infections Diagnosed?

The doctor will conduct a physical and clinical examination, and the doctor may recommend a blood test to confirm viral infection. A blood test checks the blood for specific antibodies. Antibodies indicate that the immune system is fighting viruses that may be causing stiffness or immobility related to arthritis.

• Enzyme-Linked Immunosorbent Assay (ELISA) - This test checks for specific microorganisms by detecting either antigens, or more commonly antiviral antibodies, in a current infection. Detection of antibodies confirms intermittent exposure to the virus, but is not necessarily the cause of current infection.

What Is the Treatment for Joint Immobility Induced by Viral Infections?

The treatment of virus-induced joint immobility may be the following:

• The doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen to reduce inflammation and pain.

• In case of infections like hepatitis B, hepatitis C or HIV, the doctor may treat the underlying infection with antiviral medications like Oseltamivir.

• Corticosteroids like Prednisone may be prescribed to treat autoimmunity from inflaming the joints.

What Are the Complications of Joint Immobility Induced by Viral Infections?

The complications of virus-induced joint immobility may include the following:

• Chronic Pain - The patient may have severe pain in the bones.

• Osteomyelitis - The inflammation or swelling in the bone.

• Osteonecrosis - Bone tissue dies due to lack of blood flow.

• Altered Bone Shape - A difference in leg length or shape of bone may occur.

• Sepsis - It is widespread inflammation in the body.

• Severe Disability - A person may have a severe inability to move.

• Death - Excessive immune reaction due to viral infection may lead to death.

How to Prevent Joint Immobility Induced by Viral Infections?

The best way to avoid virus-induced joint immobility is to avoid infection. Listed below are some tips for the prevention of viral infections:

• Wash hands after being near sick children or people with the virus.

• Avoid injecting banned drugs and sharing needles with others.

• Avoid unprotected sex with someone who may be infected.

• Avoid sharing personal items and utensils with infected individuals.

• Get vaccinated.

• Use safe cooking practices.

• Disinfect surfaces regularly.

• Exercising regularly.

• Drink clean water.

• Eat food at a hygienic place outside.

Conclusion

Viral arthritis occurs when certain viral infections cause joint pain, inflammation, swelling, and stiffness. The condition usually progresses rapidly, and symptoms appear within hours or days. Many viruses can cause arthritis either by attacking the joints directly or by inducing immunity to attack the joints. The most common viruses that cause arthritis include chikungunya, dengue, and parvovirus. These include B19 (especially in children), hepatitis A, B, hepatitis C, rubella, and retroviruses. The doctors treat virus-induced joint immobility with nonsteroidal anti-inflammatory drugs and sometimes antiviral drugs. Unlike other types of arthritis, infectious joint immobility is usually not a long-term condition. With timely and appropriate treatment, joint immobility caused by viral infection is generally curable. However, without proper treatment, infectious arthritis can severely damage the affected joints and spread to other parts of the body. Seeking proper treatment is important.