When knee pain is caused by Lyme disease

WABC-TV—September 16, 2009

Lyme disease is an infectious illness we can get when we're bitten by a tick.

One family in New Jersey found out a surprising way that their son had the illness, just as he was about to have surgery for a different diagnosis.

We know that often a tick bite can go unnoticed, but if Lyme disease goes untreated it can cause arthritis and worse.

So when some symptoms come up, its often a good idea to check the cause.

For 12-year-old Lukas Glaser, the problem began with some pain in his right knee.

"I was very slow. I was limping hard to run because of the pain," he said. "I was just walking and my leg started to hurt when I would bend it."

Lukas plays both lacrosse and soccer at his school in Ringwood, New Jersey, so at first no one thought much about a knee hurting.

"When he had his next game, I saw him on he field. He was trying to run and you could see how swollen his knee was," his dad, John Glaser, said.

An MRI scan revealed a small meniscus tear on the knee. The plan? Surgery the following day, but Luke's dad was hesitant.

"I said we need a second opinion and because he is so young, I didn't want to rush into surgery at that point," he said.

Luke never did have the surgery. He got several more tests and eventually came under the care of Dr. Emma MacDermott at Hospital for Special Surgery.

Luke had Lyme disease. That was the cause of the pain in his knees.

"It's not unusual for a child to have knee swelling or another large swelling as the first presentation of the Lyme disease," Dr. MacDermott said.

Children may or may not have the traditional bull's eye rash when they get a tick bite.

Even when they do, they might not tell their parents.

The unseen infection eventually begins to make its way to the joints, causing lyme arthritis.

"Lyme arthritis tends to be something that comes on acutely and very suddenly often in a large joint and almost overnight children develop a big swollen knee," MacDermott said.

Lukas's treatment has worked well to resolve his Lyme disease. Antibiotic and anti-inflammatories for 30 days. Now, he's ready to go back to the sports he loves.

"My leg feels much better. I can bend it perfectly, and I can run," he said.

When there is joint pain in a child, there can be many reasons and doctors usually have to do a series of imaging and blood tests. In this case, it turned out that his meniscus tear was an old one and not causing any problem. Lyme disease is still a big problem for both adults and children in this area. Usually, 2 blood tests, Eliza and Western Blot, are needed to confirm infection.

This story originally appeared at abclocal.com.