3) Joint/Muscle Aches
Muscle and joint ache may not be present in all patients but is a feature of hepatitis B. Once inflammation takes over the liver, there can be multiple manifestations of a diseased organ. One of these presentations is a muscle and joint pains.
There have been multiple case reports in which patients have presented with joint and muscle pains before being diagnosed with acute hepatitis B. For example, a 28-year-old woman reported having severe pain in the shoulder, elbow, and hand joints (metacarpophalangeal, proximal interphalangeal joints).
A 35-year-old man presented with a painful and stiff neck and upper and lower back joints without any evident reason. There were no other symptoms. However, serum AST was raised. HBsantigen test came out positive after seven weeks. This indicated the presence of HBV in the body that caused the aches.
A 30-year-old heroin addict was hospitalized for severe pain. The patient did not have any hepatic symptoms initially; however, he became jaundiced and had raised levels of bilirubin and alkaline phosphatase after 40 days. In this particular case, joint pain was the initial presenting symptom of hepatitis B infection.
Patients with acute hepatitis B often suffer from arthralgias (joint pains) and myalgias (muscle pains). In an old study, eighteen patients with acute hepatitis presented with arthritis and arthralgias. Acute hepatitis B can cause severe muscle and joint pain. This discomfort can be picked up well before other symptoms of the ailment start to appear.
Research suggests rheumatological manifestations (arthralgias and myalgias) are found in patients with hypothyroidism, rheumatoid arthritis, and viral hepatitis (B and C).
