Medical imaging study shows how COVID-19 ‘can trigger the body to attack itself’

Coronavirus

(LEFT) MRI of the foot in a patient with severe COVID-19; (RIGHT) MRI image of a patient’s shoulder. (Photos provided by Northwestern University)

CHICAGO (NewsNation Now) — A new study is using radiological imaging to confirm the severity and long-term impact of COVID-19 related muscle and joint pain.

Northwestern Medicine Dr. Swati Deshmukh co-authored a study Wednesday in the journal Skeletal Radiology, to help explain why some patients are experiencing prolonged musculoskeletal symptoms after COVID-19.

Many coronavirus patients suffer from muscle soreness and achy joints, and are able to recover. But doctors have seen patients experience more severe and long-lasting symptoms, such as rheumatoid arthritis flares, autoimmune myositis or pernio-like lesions of the toes, also known as “COVID toes.”

MRI of the foot in a patient with severe COVID-19. The grey part of the foot is devitalized tissue (gangrene). (Photo provided by Northwestern Medicine)

“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,” Deshmukh said in a statement.

Researchers reviewed Northwestern Memorial Hospital patient data between May and December of last year, revealing how imaging can lead to better treatment.

“Many patients with COVID-related musculoskeletal disorders recover, but for some individuals, their symptoms become serious, are deeply concerning to the patient or impact their quality of life, which leads them to seek medical attention and imaging,” said Deshmukh. “That imaging allows us to see if COVID-related muscle and joint pain, for example, are not just body aches similar to what we see from the flu — but something more insidious.” 

Deshmukh said the radiological imaging can reveal “edema and inflammatory changes of the tissues,” such as fluid and swelling. It can also show hematomas (collections of blood) or devitalized tissue (gangrene).

MRI image of a patient’s shoulder. The red arrow points to inflammation in the joint. The COVID-19 virus triggered rheumatoid arthritis in this patient with prolonged shoulder pain after other symptoms resolved. (Photo provided by Northwestern Medicine)

“In some patients, the nerves are injured (bright, enlarged) and in others, the problem is impaired blood flow (clots),” she said.

Imaging is able to reveal why some patients are experiencing these symptoms so long after contracting COVID-19, and then direct them to the right doctors for treatment. It can also prompt radiologists to suggest a coronavirus diagnosis based on imaging from patients who previously didn’t know they had the virus.

“I think it’s important to differentiate between what the virus causes directly and what it triggers the body to do,” Deshmukh said. “It’s important for doctors to know what’s happening in order to treat correctly.”

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