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"Water on the knee," which is properly known as spontaneous knee effusion, could be an early indicator of Lyme disease, a literature review concluded.

According to the review, if patients have water on the knee but not the common symptom known as a "bull's eye" rash, they should still seek out medical care in regards to Lyme disease as a precaution.

Study author Elizabeth Matzkin, MD, noted doctors would able to diagnose cases earlier via the water on the knee symptom.

"Half of patients do not recall a tick bite or observe a rash, and early symptoms are not always detected when a physician diagnoses a knee effusion," Dr. Matzkin explained. "One of the most notable differentiating factors is, while septic or arthritic knees usually come with significant pain, knee effusions caused by Lyme disease are often very large, not activity-related, and mostly pain-free."

Early treatment with antibiotics can reduce one's chances of developing more severe symptoms from the disease.

"It is important to catch and treat Lyme disease early because the symptoms get progressively worse over time," Dr. Matzkin, said in the press release. "However, the lab tests used to diagnose Lyme disease can take time to process, and there are certain circumstances in which immediate antibiotic treatment may be recommended before the lab results are complete."

Antibiotic treatments are effective in 99 percent of the early diagnosis cases. In patients who are diagnosed later, the effectiveness rate drops to 60 percent. When left untreated, the disease can lead to Lyme arthritis and permanent joint damage in very rare cases.

Early symptoms of Lyme, which do not always manifest, include fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes. These symptoms can show up as early as three days and as late as 30 days after exposure. Doctors use a two-tier blood test to check for Lyme.

The U.S. Centers for Disease Control and Prevention (CDC) stated that there are more than 300,000 reported cases of Lyme disease per a year. They estimated that about 300,000 new cases go unreported.

Lyme disease can be transmitted from infected ticks.

The review was published in the Journal of the American Academy of Orthopaedic Surgeons.