Symptoms of Lyme arthritis are similar to septic (infectious) arthritis but the treatment for these two conditions is different.
Efforts are being made to collect data that will help physicians make an early and accurate diagnosis. This is important because septic or infectious arthritis is often a surgical emergency to prevent joint destruction. Lyme arthritis requires treatment but it is not an emergency. In both cases, an accurate diagnosis is needed to direct treatment and prevent long-term complications.
The diagnosis of Lyme arthritis is a bit tricky for several reasons. One, the arthritic symptoms don’t always develop until late in the disease — sometimes months and even years after the tick bite that caused it.
Two, special highly sensitive blood tests that are used to identify Lyme disease aren’t always available in small towns or local hospitals. An enzyme immunoassay or immunofluorescent assay followed by a Western immunoblot are required. The turn around time on results can be a week or more. By the time the diagnosis is made, days to weeks may have passed.
And three, if the physician suspects septic arthritis and treats it with an antibiotic rather than the antimicrobial medication needed for Lyme disease, appropriate treatment is further delayed.
Efforts are being made to collect data that will help physicians make an early and accurate diagnosis based on clinical presentation. If the most common signs and symptoms of each condition could be categorized, a clinical diagnosis (without accurate blood tests) might be possible.