Figure 1
Magnetic resonance imaging (MRI) and bone scintigraphy of the hands and wrists of a 60-year-old man with chikungunya virus infection revealing. A. Arthritis of the 3rd metacarpo-phalangeal joint of the right hand with extensor tenosynovitis associated with intra-articular swelling (red arrow on axial section, time-resolved contrast-enhanced T1-weighted sequence after Gadolinium injection with fat suppression) B. Bilateral periostum inflammation and oedematous carpitis with synovitis predominating on the left hand (arrow on axial section, time-resolved-enhanced T2-weighted sequence with fat suppression) C. Asymmetric inflammatory carpitis with multiple synovitis of flexors of the left wrist (red arrows on axial section, time-resolved contrast-enhanced T1-weighted sequence after Gadolinium injection with fat suppression) D. Bone destruction on the left hand (red arrows on coronal section, time-resolved contrast-enhanced T1-weighted sequence with fat suppression) E. Bone scintigraphy of the wrists and hands showing an intense focus of technetium 99 m-labeled methylene disphosphonate tracer uptake, particularly in the right metacarpo-phalangeal wrist. F. Bone scintigraphy of the left foot showing an intense focus of technetium 99 m-labeled methylene disphosphonate tracer uptake, particularly in the left ankle.