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Lyme Disease

Article written by: ALIZZI KHALID, MD, Rheumatologist

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What awaits you at Centrokinetic?

Centrokinetic welcomes patients, having a complete rheumatology department, a medical branch that deals with the diagnosis, treatment, and recovery of patients with non-surgical musculoskeletal disorders. These conditions are usually painful, acute, or, most often, chronic, preventing the proper functioning of the musculoskeletal system. They are generally called rheumatism or rheumatic and musculoskeletal diseases.

Most of the times, the patient's evaluation is complex, multidisciplinary, considering the systemic, generalized character of most rheumatological diseases, that is why Centrokinetic has experienced doctors:

What is Lyme disease?

Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi, which can be transmitted to humans through the bite of an infected tick of the species Ixodes scapularis. Studies show that most people diagnosed with Lyme disease do not remember being bitten by a tick. Lyme disease was first identified in Old Lyme, Connecticut, in 1975. It is currently the most common tick-borne disease in Europe and the United States.

People who live or spend a lot of time in wooded areas are more likely to become infected, and people with pets who visit green spaces also have a higher risk of contracting Lyme disease.

Symptoms

People with Lyme disease may react to it differently, and the symptoms may have varying degrees of severity. Although Lyme disease is usually divided into three stages (early localization, early spread, and late spread), the symptoms may overlap. Some people may come to the hospital in an advanced stage of the disease without having the symptoms that appear in the initial stage. Some of the most common symptoms of Lyme disease are:

  • circular rash, the appearance of "bull's eye";
  • fatigue;
  • joint pain and swelling;
  • muscle pain;
  • headache;
  • fever;
  • lymphadenopathy;
  • sleeping disorders;
  • difficulty concentrating.

Lyme disease symptoms in children

Generally, children experience the same symptoms of Lyme disease as adults. It usually has the following symptoms:

  • fatigue;
  • muscle and joint pain;
  • fever;
  • other flu-like symptoms.

At Centrokinetic, our doctors will perform a complete clinical examination. You may have muscle and joint pain, stiffness after rest, and decreased mobility. The doctor will also do a complete, vascular, and nervous examination of the affected limb. Our medical team can complete the investigations to establish a correct diagnosis, with imaging investigations (musculoskeletal ultrasound, joint MRI), functional tests (electromyography), and arthrocentesis.

Centrokinetic has a state- of-the-art MRI device, dedicated to musculoskeletal disorders of the upper and lower limbs. The MRI machine is open, so that people suffering from claustrophobia can do this investigation without any problems. The examination duration is, on average, 20 minutes.

Blood tests are much more conclusive if we perform them a few weeks after infection because antibodies are present in the body. Our doctors may prescribe the patient to perform the following tests:

  • ELISA test that is used to detect antibodies against Borrelia burgdorferi;
  • WESTERN BLOT test, which is used to confirm a positive ELISA test.
  • Polymer chain reaction (PCR) testing is used to assess people with persistent Lyme arthritis or signs of nervous system damage. The test is performed by collecting synovial fluid from the joints or cerebrospinal fluid (CSF). PCR testing based on the cerebrospinal fluid is not a recommended routine method because of low sensitivity. A negative result does not guarantee the absence of the disease in the body. In contrast, many individuals may test positive for synovial fluid PCR if tested before starting antibiotic treatment.

Treatment

Lyme disease is best treated in the early stages.

Stage I - The first stage treatment of the disease is simple and consists of the administration of oral antibiotics for 10-14 days to eliminate the infection. Medicines used to treat Lyme disease include doxycycline, amoxicillin, cefuroxime (the first-line treatment for both adults and children). Amoxicillin and cefuroxime are also used to treat pregnant or breastfeeding women.  

Lime arthritis occurs in a late stage of the disease and affects only a small proportion of infected people. It is treated with the administration of oral antibiotics for 28 days.

If a patient has been treated for Lyme disease with antibiotics and the symptoms have not disappeared, this condition is called post-Lyme disease syndrome or post-treatment Lyme disease syndrome.

About 10-20% of people with Lyme disease have experienced this syndrome.

At Centrokinetic, our doctors can investigate, diagnose, and treat you to get the best results. They can also perform joint and periarticular injections with:

  • Anti-inflammatory solutions or corticosteroids:  are usually used for several types of musculoskeletal problems, such as tendinitis, tenosynovitis, bursitis, fasciitis, osteoarthritis, muscle injuries, ligament injuries. Corticosteroids are natural hormones made from cholesterol in the adrenal glands. In clinical practice, steroids are used for their powerful anti-inflammatory effects. Corticosteroids should not be confused with anabolic steroids, which are known to be used by athletes to increase muscle mass and strength. Corticosteroids used in resentment are injected all over the world, the administration doses are minimal, on average 0.4mg, and the side effects are similar in elderly patients, by temporarily increasing (2-3 days) blood pressure and blood sugar.
  • Sterile viscoelastic solutions (hyaluronic acid): are performed mainly intraarticularly, both in the large joints (knee, shoulder, hip, ankle) and in the small ones (fist, elbow, metatarsophalangeal, or interphalangeal). The role of these infiltrations is multiple: protector of the articular cartilage through the viscous properties of the injection - the molecules of Hyaluronic Acid in the synovial fluid, act as a lubricant, protecting the articular surfaces from mechanical damage, by elastic properties - under the pressure generated by the joint load (bodyweight), hyaluronic acid in a synovial fluid acts as a shock absorber, protecting cartilage from compressive trauma, a nutrient for joint cartilage, synovial tissue protector:  Hyaluronic acid is a protective barrier for the synovial membrane and masks the receptors for inflammation in the knee, reducing inflammation.
  • Infiltrations with PRP (platelet hyperconcentrate): have been used since 1978 in the USA, in the treatment of musculoskeletal disorders, with extraordinary results. The infiltration lasts on average 40 minutes, is painless, and consists of collecting peripheral blood (from the vein) of the patient, on average between 60 and 180 ml, centrifugation 20-25 minutes to separate platelets from other blood cells, and injection into the same stage in the affected area. Centrokinetic offers patients treatments with the best PRP kits in the world, brought from the USA, from Arthrex and Magellan. The rationale for using this type of infiltration is to initiate and accelerate the natural process of tissue healing and regeneration by releasing platelet-derived growth factors directly into the affected tissue. According to current studies, soft tissue lesions and cartilage lesions are receptive to this treatment. Some of these include the following: tendinitis (epicondylitis, plantar tendonitis, Achilles, patellar, etc.), tendinosis, tendon ruptures, tendon degenerative lesions, muscle ruptures, cartilage lesions (arthrosis). The therapy also has a postoperative indication in meniscus suture, ligamentoplasty, sutures/tendon reinsertions (rotator cuff, Bankard, Achilles tendon, patellar tendon, quadrigeminal, etc.).
  • Autologous growth factor therapy:  is a therapy used in Germany for 15 years, and consists of harvesting the body's growth factors, multiplying them by incubation, and reinjecting them into the affected area. The duration of the treatment is 3 hours, performing 3-5 procedures, at 1-week intervals. The major indications are chronic tendinitis (epicondylitis, plantar tendonitis, Achilles, patellar), and articular cartilage lesions (arthrosis). It also has excellent results in the treatment of joint and periarticular pain.  Autologous growth factor therapy is a treatment with a cytokine-rich autologous serum (ACRS), derived from the patient's blood. To ensure high tolerability, this technology completely avoids the use of any artificial additives. This special serum, rich in autologous cytokines, can activate the body's ability to heal itself by producing positive interleukins and growth factors. These are crucial to intervene in the cascade of pain, causing it to stop and the subsequent onset of the healing process.

Centrokinetic clinic has a very experienced team, specialized in sports traumatology, accredited in: Tecar therapy, dynamic taping, massage, Graston technique, Kinesio Tape, ERGON, flossing band. Our team has attended numerous overspecialized courses with trainers from the country and abroad, being certified to perform therapies at the highest level. 

About Centrokinetic

Centrokinetic clinic offers all services necessary for a complete rehabilitation process, from the first consultation to the medical specialist to establish the correct diagnosis, to treatment and recovery.

Centrokinetic is the place where you will find clear answers and solutions for your motricity problems. The clinic is dedicated to osteoarticular conditions and is divided into the following departments:

  • Orthopedics, a department composed of an extremely experienced team of orthopedic doctors, led by Dr. Andrei Ioan Bogdan, primary care physician in orthopedics-traumatology, with surgical activity at Medlife Orthopedic Hospital, specialized in sports traumatology and ankle and foot surgery.
  • Pediatric orthopedics, where children's sports conditions are treated (ligament and meniscus injuries), spinal deformities (scoliosis, kyphosis, hyperlordosis) and those of the feet (hallux valgus, hallux rigidus, equine larynx, flat valgus, hollow foot).
  • Neurology, which has an ultra-performing department, where consultations, electroencephalograms (EEG) and electromyography (EMG) are performed. 
  • Medical recovery  for adults and  children, department specialized in the recovery of performance athletes, in spinal disorders, in the recovery of children with neurological and traumatic diseases. Our experience is extremely rich, treating over 5000 performance athletes.
  • Medical imaging, the clinic being equipped with ultrasound and MRI, high-performance devices dedicated to musculoskeletal disorders, and complemented by an experienced team of radiologists: Dr. Sorin Ghiea and Dr. Cosmin Pantu, specialized in musculoskeletal imaging.

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