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Possible link between Zika virus and severe joint condition at birth

New research has shown a possible link between Zika virus infection in the womb and arthrogryposis – a condition which causes joint deformities at birth, particularly in the arms and legs. 

After the outbreak of microcephaly in Brazil associated with Zika virus, reports suggested an association between congenital viral infection and arthrogryposis. 

Zika virus link
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So a research team based in Recife – the Brazilian city at the centre of the Zika epidemic – studied brain and joint images of seven children with arthrogryposis and a diagnosis of congenital infection, presumably caused by Zika. 

All the children tested negative for the five other main causes of microcephaly – toxoplasmosis, cytomegalovirus, rubella, syphilis and HIV – and all showed signs of brain calcification, a calcium build-up in the brain. The theory is that the Zika virus destroys brain cells and forms lesions similar to ‘scars’ on which calcium is deposited. 

When all the children underwent high definition scanning of the joints and surrounding tissues, there was no evidence of joint abnormalities. 

Based on this, the researchers said arthrogryposis was unrelated to the abnormalities of the joints themselves, but was possibly of neurogenic origin, ‘with chronic involvement of central and peripheral motor neurones leading to deformities as a result of fixed postures in the womb.’ 

They said further research is needed to study the neurological abnormalities behind arthrogryposis, but suggested that children should receive orthopaedic follow-up because they could develop musculoskeletal deformities secondary to neurological impairment.

‘Congenital Zika Syndrome should be added to the differential diagnosis of congenital infections and arthrogryposis’ the study authors said. 


Van der Linden V et al (2016) Congenital Zika syndrome with arthrogryposis: retrospective case series study. BMJ.

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