Recent radiology findings published in Skeletal Radiology by a Northwestern Medicine team pinpointed the causes of COVID-19 symptoms. CT, MRI, and ultrasound images unmask the virus’ pathways within the body and how it prompts the immune system to attack itself.

Sore muscles and achy joints are common symptoms of COVID-19 in some people. For others, the virus can spark otherwise dormant (or managed) rheumatoid arthritis, autoimmune myositis, or swollen and discolored toes, called “COVID toes.”

Corresponding author Swati Deshmukh, M.D., assistant professor of radiology at Northwestern University Feinburg School of Medicine, said, “We’ve realized that the COVID virus can trigger the body to attack itself in different ways, which may lead to rheumatological issues that require lifelong management. Many patients with COVID-related musculoskeletal disorders recover, but for some individuals, their symptoms become serious, impacting the quality of their life, which leads them to seek medical attention and imaging.”

Patients admitted to Northwestern Memorial Hospital between May 2020 and December 2020 were examined with CT, MRI, and ultrasound. Their results were analyzed and used to discover why certain people have lingering musculoskeletal symptoms post-COVID-19. 

Edema, inflammatory changes in tissues, hematomas, and gangrene were all expressed in the patients; additionally, some images showed enlarged nerves which indicate injury or blood clots.

With these scans, radiologists can better direct patient care by steering them to a rheumatologist or dermatologist for further treatment. Radiologists could also suggest a COVID-19 diagnosis in patients who might have been unaware they had the virus. Overall, radiologists can use this information to improve patient outcomes. If a radiologist is familiar with the rheumatoid arthritis-prompting effects of COVID-19, they can send a patient with visible joint inflammation to a rheumatologist for further evaluation.

The study explores several types of musculoskeletal abnormalities, including visual samples of what radiologists should look for. Imaging providers should be alert and note the likelihood that pertinent findings are lurking in those images. This was (and is) not standard practice, because many radiologists were unsure what they were looking for. Now, with the results from this study, there is a clearer picture and understanding of the COVID-19’s progression.


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