Rheumatoid arthritis

Water on the knee can be Lyme disease

Wednesday, 4 Nov 2015

Spontaneous knee effusion can be a primary symptom of Lyme disease, according to a literature review.

Writing in The Journal of the American Academy of Orthopaedic Surgeons Elizabeth Matzkin, MD, lead study author and assistant professor of orthopaedic surgery at Harvard Medical School said it was important to catch and treat Lyme disease early because the symptoms get progressively worse over time.

If left untreated, 60 percent of patients eventually develop Lyme arthritis, with the most severe cases having higher risks of permanent joint damage.

“Half of patients do not recall a tick bite or observe a rash, and early symptoms are not always detected when a physician diagnoses a knee effusion,”  Dr. Matzkin said.

“One of the most notable differentiating factors is, while septic or arthritic knees usually come with significant pain, knee effusions caused by Lyme disease are often very large, not activity-related, and mostly pain-free.”

In areas where Lyme disease is common, physicians should always consider whether a spontaneous knee effusion might be caused by the disease and test accordingly.

In areas of low prevalence, the clinician should ask if the patient has traveled to such an area before making a diagnosis, she added.

The existence of Lyme disease in Australia has been hotly disputed.

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