Ortiz Carlos D, Barsi James
Renaissance School of Medicine at Stony Brook University, Stony Brook, NY.
Stony Brook University Hospital, Department of Orthopaedics, Stony Brook, NY.
J Pediatr Soc North Am. 2024 Feb 12;5(3):706. doi: 10.55275/JPOSNA-2023-706. eCollection 2023 Aug.
Septic arthritis and Lyme arthritis are two conditions that can present with similar symptoms, making it challenging to differentiate between them in a clinical setting. While septic arthritis often requires immediate surgical intervention, Lyme arthritis can often be managed effectively with antibiotic therapy alone. However, given the dangerous nature of untreated septic arthritis, accurate diagnosis and timely intervention are crucial in managing the condition, especially in the pediatric population. Efforts to distinguish between the two conditions include the use of laboratory tests, history and physical exam findings, and MRI imaging. The authors aim to explore the causes, presentation, and treatment of septic versus Lyme arthritis as well as to provide a summary of the evolving research in this area and propose an algorithm that can aid in diagnosis. By synthesizing the proposed algorithm in diagnosis, clinicians will be better equipped to manage septic versus Lyme arthritis effectively while avoiding invasive procedures such as joint aspiration.
•Septic arthritis is a medical urgency that requires prompt diagnosis and treatment to achieve positive clinical outcomes.•Arthritis is a late-stage symptom of Lyme disease that can be challenging to distinguish from septic arthritis.•Laboratory tests, a thorough history & physical exam, and MRI imaging can aid in diagnosis and help clinicians manage these conditions without resorting to invasive procedures like arthrocentesis.•While septic arthritis usually requires joint drainage, Lyme arthritis can be managed effectively with antibiotic therapy.
化脓性关节炎和莱姆关节炎是两种可能表现出相似症状的疾病，这使得在临床环境中区分它们具有挑战性。虽然化脓性关节炎通常需要立即进行手术干预，但莱姆关节炎通常仅用抗生素治疗就能有效控制。然而，鉴于未经治疗的化脓性关节炎的危险性，准确诊断和及时干预对于控制病情至关重要，尤其是在儿科人群中。区分这两种疾病的方法包括使用实验室检查、病史和体格检查结果以及磁共振成像（MRI）。作者旨在探讨化脓性关节炎与莱姆关节炎的病因、表现和治疗方法，并总结该领域不断发展的研究成果，提出一种有助于诊断的算法。通过在诊断中综合运用所提出的算法，临床医生将能更好地有效管理化脓性关节炎与莱姆关节炎，同时避免诸如关节穿刺等侵入性操作。
•化脓性关节炎是一种医疗急症，需要迅速诊断和治疗以取得良好的临床效果。•关节炎是莱姆病的晚期症状，可能难以与化脓性关节炎区分开来。•实验室检查、全面的病史和体格检查以及MRI成像有助于诊断，并帮助临床医生在不借助关节穿刺等侵入性操作的情况下管理这些疾病。•虽然化脓性关节炎通常需要关节引流，但莱姆关节炎用抗生素治疗可以有效控制。
