Early, correct diagnosis is the best way to prevent the development of Lyme arthritis in individuals with the tick-borne illness, according to a paper published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). In patients who do develop the condition, most cases can be treated successfully with antibiotics, the review found.
"Lyme arthritis occurs commonly in patients with Lyme disease and should be considered when evaluating patients with joint complaints and who live in areas where the disease occurs," said study author Aristides Cruz, MD, chief orthopaedic resident, Yale-New Haven Hospital. "When diagnosed early, most patients do not develop Lyme arthritis. But when correct diagnosis is delayed, arthritis can occur and requires intervention before permanent joint damage develops."
Lyme arthritis can be defined as a painful, swollen joint, that causes a stiffness similar to osteoarthritis, and occurs most commonly in the late stages of Lyme disease, usually several months after the onset of the disease. About 60 percent of patients who are left untreated for Lyme disease in its early stages will develop Lyme arthritis, Dr. Cruz said.
"Lyme arthritis occurs when the spirochete, the bacteria that causes the disease, invades the joints and causes inflammation to the tissue that lines the joints," he said. "If left untreated, this inflammatory response can cause the cartilage within the joints to become damaged."
Dr. Cruz said most cases of Lyme arthritis are brief and involve a single joint, most typically the knee. The ankle, elbow, hip and wrist may also be affected, and some patients may develop a fever. Following an initial period of joint pain and swelling lasting from a week to several 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.
http://www.medicalnewstoday.com/articles/215576.php
Copyright ArthritisInsight.com