Unusual musculoskeletal manifestations of Lyme disease.Schmitz G, Vanhoenacker FM, Gielen J, De Schepper AM, Parizel PM.
Department of Radiology, University Hospital Antwerp, Antwerp, Belgium.
We report on the imaging features of musculoskeletal abnormalities in a 52-year-old woman suffering from Lyme disease presenting with acrodermatitis chronica atrophicans (ACA).
The patient developed recurrent attacks of migratory asymmetrical oligoarthritis, involving articular and peri-articular structures, including the metatarsophalageal (MTP) joints, scapular bone, thoracic spine, elbow, gluteal area, knee, ankle and metacarpophalangeal (MCP) joints.
Six months after the first symptoms, Magnetic Resonance Imaging (MRI) showed bone marrow oedema within the proximal phalanx of the right fifth toe, adjacent to an ACA rash.
A year after the onset of the disease, swelling at the right scapular region occurred, and MRI showed osseous, periosteal and soft tissue involvement of the superior margin of the right scapula and adjacent rib.
On MRI of the spine, there was bone marrow infiltration with irregular delineation of the anterior corner of the thoracic vertebrae 4 to 6, corresponding to an osteoblastic bony lesion on radiographic examination.
This case report is unique, because MRI documentation of bony abnormalities and periarticular soft tissue swelling, accompanying an attack of ACA has never been reported previously.
Moreover, involvement of the osseous spine and the scapular bone have never been described in the radiological literature.
PMID: 15587559 [PubMed - indexed for MEDLINE]
Posted by daise (Member # 13622) on :
I had a huge, warm lump above my right knee, in the femur bone. This happened suddenly (in the same hour) as Bell's palsy, arthritis in my right knee and shoulder, severe muscle pain and nearly all of my Lyme signs and symptoms.
Eventually, I was diagnosed with a bone infarct in the femur. (It's not cancer.)
According to the above paper, possibly it could be caused by Lyme. But I also understand it could be caused by bartonella.
I'm being treated for both. Any thoughts?
daise Posted by Pure Lymie League (Member # 10421) on :
I have bone protrusions on my knees. I asked Dr.C. about them and he didn't seem
to know, so I've just ignored them. Sara
Posted by Tincup (Member # 5829) on :
Daise said..
"According to the above paper, possibly it could be caused by Lyme. But I also understand it could be caused by bartonella."
You are right. I'm afraid I can't say for sure.. but it is interesting to know that maybe both can be the cause.
I also wonder on some of the abstracts and in the conclusions they've made if they even tested patients for Bart?
I've seen this happen in some Parvo abstracts.. where the folks remained ill with LYME.. but it wasn't considered.
Hey Pure...
Do they hurt?
I hope not!
Posted by JudyEric (Member # 4070) on :
My son had a lot of pain in both feet after playing soccer last Labor Day. Eventually the orthopedic doctor did an MRI and he had bone marrow edema (calcaneous and some tarsal bones) and a stress fracture in the left foot (the only one he did an MRI on). He stopped all sports activities until Thanksgiving. When he started to run again the pain was still present and bone marrow edema was found in the other foot.
By this time his knees were also hurting and the orthopedic doc had run a screening test for Lyme which was positive. My son had Lyme in 2002 and I guess it never was completely treated. We ran back to our LLMD.
He has been clinically diagnosed with Bartonella also. He has developed a large deformed barrel chest over the years. I wonder if that is also related to the Lyme/Bart?
--Judy
Posted by daise (Member # 13622) on :
Judy
I'm sorry to hear your son, you and your family have gone through this.
What does the LLMD say about his chest?
daise Posted by daise (Member # 13622) on :
Thanks Tincup,
Yea, perhaps it's Lyme and bart.
Maybe the bart went after the immune factory in my femur and Lyme jumped on it, too.
It's interesting that it took 9 years from the time of the bull's-eye to the time I had very sudden signs and symptoms of Lyme.
I was also severely hypothyroid.
I wonder if I've had bart since I was a girl in Minnesota.
![[Smile]](smile.gif)
![[Big Grin]](biggrin.gif)