Differential Diagnosis for Chronic Joint Pain and History of Tick Bite
- Single most likely diagnosis
- Lyme disease: This is the most likely diagnosis given the history of tick bite and chronic joint pain. Lyme disease, caused by the bacterium Borrelia burgdorferi, is known to cause arthritis and other joint-related symptoms, especially if left untreated or inadequately treated.
- Other Likely diagnoses
- Osteoarthritis: This is a common cause of chronic joint pain and could be considered, especially in older patients or those with a history of joint trauma or overuse.
- Rheumatoid arthritis: An autoimmune disorder that causes chronic inflammation and pain in the joints, which could be a consideration if the patient presents with symmetric joint involvement and morning stiffness.
- Psoriatic arthritis: If the patient has a history of psoriasis, this condition, which causes joint pain and inflammation, should be considered.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Septic arthritis: Although less likely, this condition is a medical emergency that requires prompt diagnosis and treatment to prevent joint destruction and potential systemic infection.
- Tuberculosis (TB) of the joint: TB can cause chronic joint pain and has a varied presentation, making it a "do not miss" diagnosis due to its potential severity and the need for specific treatment.
- Rare diagnoses
- Lyme disease co-infections (e.g., anaplasmosis, babesiosis): These are less common but can occur in patients with a history of tick bites and may present with similar or additional symptoms.
- Relapsing fever: Caused by other Borrelia species transmitted by ticks, this condition is characterized by recurring episodes of fever and could be considered in endemic areas.
- Southern tick-associated rash illness (STARI): Although it presents primarily with a rash, it's associated with tick bites and could be considered in patients with joint pain and a history of tick exposure in specific geographic areas.