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Effective Treatment of Lyme Disease-Related Arthritis Depends on Proper Diagnosis
Date:2/2/2011

eral months, symptoms may recur until the disease is diagnosed. In the acute and late stages, Lyme disease may be difficult to distinguish from other disease processes, he added.

"Diagnosing Lyme arthritis can be problematic, especially in patients who do not report a rash and who have fever, since it can be confused with a bacterial joint infection, particularly in children," Dr. Cruz said. "In general, the diagnosis is multifaceted and involves a thorough understanding of the common clinical and epidemiologic features of the disease, along with careful understanding of the tests used in diagnosis."

"In most patients, Lyme arthritis can be successfully treated with oral antibiotics," Dr. Cruz said. "Nonsteroidal anti-inflammatory drugs may also be given to help manage symptoms while the patient is improving."  A small number of patients may continue to have symptoms even after treatment with antibiotics, Dr. Cruz said. In these patients, surgical treatment may be needed to remove the diseased synovial tissue.

To help ensure a speedy diagnosis, Dr. Cruz said individuals who live in areas where Lyme disease is known to be present should look for the following symptoms and report them to their physician:

  • Rash which develops near an insect bite on the skin
  • Aching, redness or swelling in one or more joints especially the knee
  • Fever
  • Lethargy or malaise
  • Headache

Dr. Cruz said that although rash occurs in the majority of patients exposed to the Lyme bacteria, in many patients who develop Lyme arthritis, the rash either never develops or goes unnoticed.

"In the classic form of Lyme disease, a rash occurs, which resembles a bull's eye," he said. "The fact that this rash does not always occur or is not reported in patients with Lyme arthritis makes the condition even more difficult to accurately diagnose."

Patients who suspect they may have been
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SOURCE American Academy of Orthopaedic Surgeons
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