Not usually considered to be one of the symptoms of Lyme disease, osteoarthritis can sometimes be confused with the joint pain and swelling that does affect some patients infected with Borrelia. However, Lyme arthritis usually causes symptoms more akin to rheumatoid arthritis, such as joints that are swollen and warm to the touch, a low-grade fever, and general malaise or fatigue.
Lyme arthritis usually affects a single large joint, such as a knee or ankle, which can help differentiate it, in turn, from rheumatoid arthritis which is commonly symmetrical in nature, affecting both knees for example rather than just one. Osteoarthritis is usually more insidious, developing without much swelling or warmth, and often occurs at a number of sites in the body where wear and tear has occurred over the years, such as the knees, shoulders, wrists, and hips. A diagnosis may involve the aspiration of fluid from the swollen joint to test for inflammatory markers, and possible bacterial infection. A blood test for Lyme disease may also be ordered if there is suspicion of infection following a tick bite.
Misdiagnosed Lyme Arthritis
Older patients who have had very active lives may dismiss joint pain and tenderness as osteoarthritis initially when these could be symptoms of Lyme disease. Some patients are misdiagnosed with depression due to non-specific aches and pains and no clear evidence of joint degeneration on x-rays or other diagnostic imaging scans. Fibromyalgia patients may discover after many years that their symptoms were also due to Lyme disease, making joint pain, osteoarthritis and Lyme disease very complex conditions to diagnose and treat in some cases. In late stage Lyme disease arthritis of one or two of the larger joints may occur alongside Lyme disease neuropathy, and possible neurological dysfunction including memory loss, concentration problems, confusion, dizziness, and mental ‘fog’.
Some patients with apparent osteoarthritis are surprised to find that their symptoms begin to improve following antibiotic treatment for a different medical condition. The explanation in such cases may be that Lyme disease ‘osteoarthritis’ was present, rather than clear-cut osteoarthritis itself. Lyme arthritis, where it is diagnosed and treated, usually resolves following a four week course of doxycycline, amoxicillin, or ceftin. Patients with severe Lyme carditis, or with neurological complications of Lyme disease may require intravenous ceftriaxone treatment however, which would also address Lyme disease osteoarthritis.
Continue Reading –> How Lyme Disease Can Trigger Osteoarthritis