When a child arrives at the ER with a swollen joint, it can be challenging for doctors to quickly determine whether it’s a musculoskeletal infection, Lyme arthritis, or inflammatory arthritis. Musculoskeletal infections (bone or joint infections) require urgent treatment to prevent complications like sepsis and joint destruction. If such an infection is suspected, doctors may perform arthrocentesis, a procedure which involves removing joint fluid, and young children may need sedation. Since Lyme arthritis doesn’t require this invasive procedure and current Lyme diagnostic tests can take days to return results, researchers have been searching for a rapid method to distinguish musculoskeletal infections from other conditions to avoid unnecessary procedures.
A new study led by Global Lyme Alliance grantee, Dr. Lise Nigrovic at Boston Children’s Hospital, and her colleagues found that a combination of three immune markers (IL-6, IL-17A, and CSF-1) are significantly better at differentiating musculoskeletal infections from Lyme or inflammatory arthritis than 5 commonly available plasma biomarkers.
To reach these findings, Dr. Nigrovic and colleagues analyzed blood samples from children undergoing emergency evaluations for joint infections. These samples came from GLA supported Pedi Lyme Net, a pediatric Lyme disease network, as well as other hospitals. Using a specialized cytokine testing platform, researchers compared cytokine levels in children with musculoskeletal infections, Lyme arthritis, and inflammatory arthritis. The study found that the three-cytokine panel outperformed traditional diagnostic markers, accurately identifying children at risk while minimizing unnecessary procedures.
Once further validation is completed, this research could ultimately help doctors make quicker, more accurate decisions for kids, ensuring they get the right treatment with fewer risks and less stress.
Publication: Geanacopoulos AT, Lee PY, Lyons TW, et al. Utility of Cytokine Biomarkers for the Diagnosis of Pediatric Pyogenic Musculoskeletal Infections. Open Forum Infect Dis. 2025;12(4):ofaf139. Published 2025 Mar 8. doi:10.1093/ofid/ofaf139
About Pedi Lyme Net: Pedi Lyme Net is a pediatric emergency department Lyme disease network composed of 8 different emergency departments. It is under the leadership of GL A grantee Lise Nigrovic, MD, MPH, Senior Pediatric Emergency Physician at Boston Children’s Hospital and Professor of Pediatrics at Harvard Medical School. It includes the world’s only pediatric Lyme Disease Biobank with over 6,000 biosamples collected since 2015. These samples have supported over 20 impactful studies, such as the one mentioned above, and fostered 11 research collaborations, advancing the understanding of pediatric Lyme disease diagnosis and management.
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