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Arthritis and Rheumatism

Onset of joint pain

04/23/2007

Question:

I have recently been having unusual pain in my elbows and knees. One year ago my lowest disc in my back became slightly herniated, and I assumed that the numbness and icy or boiling hot feelings in my feet were due to that. Over the past 2 years I have been battling extreme fatigue, not relieved by diet or excersize. 3 years ago I found a tick burrowed into my right hip, tried to get it out, and found that I had only the body. Lyme disease?

Answer:

Lyme Disease can have an arthritis associated within the spectrum of clinical manifestations. However, typically, the arthritis presents within a matter of months (2 – 6 months) as opposed to years. Another common feature in Lyme Disease that you did not describe was a red skin rash around the tick bite in the shape of a bullseye. This is frequent symptom and typically occurs within days to weeks of the tick bite.

There are blood tests to screen for Lyme Disease; however, false positives in the lab assay can occur. Therefore, at least a moderate clinical suspicion for Lyme Disease should exist in conjunction with an abnormal Lyme Disease laboratory in order to consider a diagnosis. Speak to your primary care physician or an infectious disease specialist if for further information.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University