Spontaneous knee effusion may be a symptom of Lyme disease

Spontaneous knee effusion can be a primary symptom of Lyme disease, even without the presence of other primary symptoms, according to results of a literature review.

Researchers of the review noted knee effusion in patients with Lyme disease may appear in the early disseminating stage or in the late disseminating stage as part of Lyme arthritis. Lyme arthritis is developed by 60% of patients with untreated Lyme disease and can lead to permanent joint damage.

Researchers noted the current standard of care for the diagnosis of Lyme disease is a two-tiered blood test using with an enzyme-linked immunosorbent assay and an immunoblot analysis for confirmation. Antibiotics can be used to treat Lyme disease, with 99% of patients diagnosed during early localized infection and 90% of patients with Lyme arthritis responding to therapy, according to results. Researchers also noted clinicians should ask patients with spontaneous knee effusion if they have a history of Lyme disease, as symptoms of post-treatment Lyme disease syndrome can mimic the symptoms of Lyme disease.

“Lyme disease should always be considered in the differential diagnosis in patients presenting with a spontaneous knee effusion, especially in areas with a known high prevalence of Lyme borreliosis,” Elizabeth Matzkin, MD, told Healio.com/Orthopedics. “Timely recognition and antibiotic treatment will result in symptom resolution and avoidance of later manifestations of the disease.” – by Casey Tingle

Disclosures: Matzkin reports she received research or institutional support from Zimmer. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Matzkin E, et al. J Am Acad Orthop Surg. 2015;doi:10.5435/JAAOS-D-14-00388.