joints with lyme arthritis

How To Test For Lyme Arthritis

Lyme disease can lead to many different health conditions. This is because the bacteria that causes Lyme, Borrelia burgdorferi, can hide out in the body’s lymph nodes and tissues and evade treatment from antibiotics, even in cases that are treated early. Unless a Lyme disease infection is detected immediately following the discovery a tick bite, it can also be difficult to diagnose because its symptoms and ailments often mimic those of other diseases.

Lyme disease is often referred to as “the great imitator” because of this fact. Some specific diseases that Lyme disease is often mistaken for include chronic fatigue syndrome, fibromyalgia, multiple sclerosis, and depression. In some cases, people with Lyme disease can develop a disease that appears exactly as rheumatoid arthritis. This condition is known as Lyme arthritis.

Does Lyme disease give you arthritis?

The condition known as Lyme arthritis presents itself as a typical case of arthritis, but is different in the way that it develops. This is because it is caused by the Lyme-inducing bacteria mentioned above. When the Borrelia bacteria enters the tissues of the joints and causes inflammation, it can lead to the symptoms associated with typical arthritis. In some cases, this joint damage can be permanent, a lot like other arthritic conditions.

The main symptom of Lyme arthritis is swelling of one or a few joints that is obvious in nature. It can affect any joint, including large joints such as the shoulders, ankles, elbows, jaw, or hips, but is most typically found in the knees. The onset of Lyme arthritis typically occurs between one or three months after the initial infection. Anyone with a Lyme disease infection is at risk of developing Lyme arthritis; in fact, around 60% of people with Lyme disease end up developing Lyme arthritis.

There are some other signs and symptoms that Lyme arthritis may be the culprit behind joint swelling. Typically, arthritic conditions tend to affect both the left and right joints equally. Lyme arthritis is often asymmetrical in the sense that it affects only one joint on one side of the body. The pain felt from Lyme arthritis is also only felt in around one to five joints at a time, and isn’t constant.

man's knees over water
Image by Chris Lawton on Unsplash: Lyme arthritis can present in any joints, but typically affects the knees.

What does Lyme arthritis feel like?

Lyme arthritis presents similarly to other arthritic conditions, but there are some stark differences. For example, the joints that are swollen in Lyme arthritis may look worse than they actually are. A person with Lyme arthritis may experience significant swelling in a knee joint, for example, but the swelling itself could appear much more painful than it actually is.

That doesn’t mean that there isn’t any pain, though. Typically, Lyme arthritis pain will feel achy and the joint will feel stiff. The pain is often worse when the joint is moved. The affected joint may also feel warm when touched.

How is Lyme arthritis diagnosed?

It can be incredibly difficult to diagnose Lyme arthritis, especially if a person is unaware that they have been exposed to the Borrelia bacteria via tick bite. If a person is unaware that their symptoms could possibly be from Lyme disease, doctors may mistake their symptoms for other types of arthritis. Those with symptoms of the disease will likely go through a physical examination prior to any other Lyme arthritis test. The examination will help to determine how many joints are affected, whether they are on both sides, and the level of swelling versus the level of pain a person feels.

Following a physical exam, a serologic test will be done to help determine if Lyme disease is present. The serological test is typically a two-step approach that can detect antibodies for the Borrelia bacteria. If there are, that means that a Lyme infection had occurred. The two serological tests used are the enzyme-linked immunosorbent assay (ELISA) and the Western Blot test.

Lyme disease tick on leaf
Image by Erik Karits on Unplash: Lyme disease is transmitted by infected ticks.

A test of synovial fluid may also be done for people with a suspected case of Lyme arthritis. The test will typically be a polymerase chain reaction (PCR) test; however, this is only used as an optional test in the effort to support a positive diagnosis received from a positive result of the serological tests.

Joint aspiration – a procedure that removes fluid from around the joint – may also be done to help rule out other types of arthritis. An MRI may also be performed to help determine the extent of the Lyme arthritis infection and the damage done to the joints. This final test is likely used to help plan treatment, if any is required outside of antibiotics.

Lyme arthritis has the ability to hide in plain sight in the sense that it can mimic other types of arthritis and be difficult to diagnose. This is especially true if people are unaware that they have a Lyme infection at all. The best way to avoid Lyme arthritis is by avoiding Lyme disease altogether, so remember to be tick-safe, particularly when spending time in wooded areas.

Featured image by Lucaxx Freire on Unsplash

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