Re: Re: question about symptoms(reply)

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In a message dated 8/13/2006 6:41:57 P.M. Mountain Daylight Time,

scorpionallure@... writes:

does anyone have only the muscle pain and fatigue? I have no

arthritis.

1: AJR Am J Roentgenol. 2005 Jun;184(6):1904-9. Related Articles, Links

MRI features of Lyme arthritis in children.

Ecklund K, Vargas S, Zurakowski D, Sundel RP.

Department of Radiology, Children's Hospital, 300 Longwood Ave., Boston, MA

02115, USA. kirsten.ecklund@...

OBJECTIVE: Oligoarthritis is the most common manifestation of late Lyme

disease in children. Considerable overlap can occur in the clinical

presentation of Lyme arthritis and acute septic arthritis. Early

differentiation is critical, given the disparate therapeutic implications;

Lyme arthritis is treated with outpatient oral antibiotics, while septic

arthritis requires hospitalization, IV antibiotics, and, often, surgical

drainage. We wanted to identify MRI features that may distinguish Lyme

arthritis from septic arthritis in children. MATERIALS AND METHODS: Knee MR

images in 11 children with Lyme arthritis and 7 with septic arthritis, with

a mean age 10.6 years old and 11.7 years old, respectively, were reviewed by

a radiologist blinded to the final diagnosis. Joint effusion size, synovial

thickness, adenopathy, subcutaneous, marrow, and muscle edema on MRI; and

clinical parameters including age, sex, fever, WBC, erythrocyte

sedimentation rate, C-reactive protein, and joint fluid WBC in the two

patient groups were compared using univariate and multivariate analyses.

RESULTS: Subcutaneous edema was seen in all septic arthritis patients but in

only one of 11 patients with Lyme arthritis (p < 0.01). Myositis and

adenopathy were present in all Lyme arthritis patients and two of seven

patients with septic arthritis (both p < 0.01). No significant difference

was present in synovial thickness, marrow edema, or joint fluid size. There

were no statistically significant differences in the clinical parameters

assessed. CONCLUSION: Our results identified three MRI features,

specifically, myositis, adenopathy, and lack of subcutaneous edema, that

strongly suggest the diagnosis of Lyme arthritis rather than septic

arthritis in children with acute inflammation of the knee. Awareness of

these characteristic MRI features may avoid unnecessary invasive procedures

and cost.

PMID: 15908551 [PubMed - indexed for MEDLINE]