Related Experiment Video
Updated: Aug 15, 2026
Feeding of Ticks on Animals for Transmission and Xenodiagnosis in Lyme Disease Research
Published on: September 1, 2013
Orthopaedic complications of Lyme disease in children
1Department of Orthoapedic Surgery, Childrens' Hospital Philadelphia, PA 19104.
Abstract:
Lyme disease is transmitted by the tick Ixodes dammini ("deer tick") or a related ixodid tick. Early diagnosis of children with Lyme disease is difficult because the bite of the ixodid tick often goes unnoticed. Furthermore, erythema chronicum migrans, the characteristic rash of the disease, occurs in less than 50% of cases. However, an awareness of orthopaedic complications of Lyme disease may facilitate an early diagnosis of this disease. Orthopaedic complications of Lyme disease include those which are oligoarticular in nature. Brief intermittent attacks of swelling and pain in one or more joints--primarily large ones--is the pattern of disease most frequently presented. The knee is the joint most commonly affected. In most cases, pain is not severe enough to debilitate the patient or prevent weight-bearing activity. An elevated sedimentation rate is the only consistently abnormal routine laboratory finding in Lyme disease. The only radiographic abnormalities noted in children are effusion and osteopenia. However, the radiograph of a patient known to have Lyme disease may not show any abnormalities at all. Lyme disease shares symptoms in common with septic arthritis and juvenile rheumatoid arthritis. Whenever a distinction between Lyme arthritis and septic arthritis is difficult to make, treatment should be directed at septic arthritis while serological tests for Lyme disease are pending. The physician should consider Lyme disease to be a possible diagnosis of any patient with arthritis and a history of rash or fever, idiopathic neurological disease, or a cardiac conduction defect--especially if there is a history of possible exposure to the carrier tick.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Early diagnosis of Lyme disease in children is challenging due to unnoticed tick bites and infrequent rashes. Recognizing orthopedic complications, like intermittent joint pain, can aid in earlier detection of this tick-borne illness.
Area of Science:
- Infectious Diseases
- Pediatric Orthopedics
- Rheumatology
Background:
- Lyme disease, transmitted by Ixodes ticks, presents diagnostic challenges in children.
- The characteristic rash (erythema chronicum migrans) is absent in over 50% of cases, complicating early identification.
- Tick bites often go unnoticed, further hindering timely diagnosis.
Purpose of the Study:
- To highlight the significance of orthopedic complications in facilitating early Lyme disease diagnosis in children.
- To inform clinicians about the typical presentation of Lyme arthritis in pediatric patients.
- To differentiate Lyme arthritis from other joint conditions like septic and juvenile rheumatoid arthritis.
Main Methods:
- Review of clinical presentations of Lyme disease in children, focusing on orthopedic manifestations.
- Analysis of laboratory and radiographic findings in pediatric Lyme disease.
- Comparison of Lyme arthritis symptoms with septic arthritis and juvenile rheumatoid arthritis.
Main Results:
- Oligoarticular arthritis, characterized by intermittent swelling and pain in large joints (especially the knee), is a common orthopedic complication.
- Elevated sedimentation rate is the most consistent laboratory finding.
- Radiographic findings in children may include joint effusion and osteopenia, though some patients show no abnormalities.
- Lyme arthritis shares symptoms with septic and juvenile rheumatoid arthritis, necessitating careful differential diagnosis.
Conclusions:
- Awareness of orthopedic complications, such as intermittent joint pain, can significantly aid in the early diagnosis of Lyme disease in children.
- In cases of suspected septic arthritis, treatment should commence promptly while awaiting Lyme disease serological test results.
- Lyme disease should be considered in pediatric patients presenting with arthritis, especially if accompanied by a history of rash, fever, neurological issues, cardiac defects, or potential tick exposure.
Related Concept Videos
01:28Disorders of the Skeletal Muscle
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
01:26Tonsillitis II: Management
01:26Rocky Mountain Spotted Fever
01:22Bacterial Meningitis I: Introduction
01:26Bacterial Meningitis II: Pathophysiology
01:19Encephalitis l: Introduction