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Review
. 2015 Jun;29(2):269-80.
doi: 10.1016/j.idc.2015.02.004.

Diagnosis and treatment of Lyme arthritis

Sheila L Arvikar  1 , Allen C Steere  2
Affiliations
Review

Diagnosis and treatment of Lyme arthritis

Sheila L Arvikar et al. Infect Dis Clin North Am. 2015 Jun.

Abstract

In the United States, Lyme arthritis is the most common feature of late-stage Borrelia burgdorferi infection, usually beginning months after the initial bite. In some, earlier phases are asymptomatic and arthritis is the presenting manifestation. Patients with Lyme arthritis have intermittent or persistent attacks of joint swelling and pain in 1 or a few large joints. Serologic testing is the mainstay of diagnosis. Synovial fluid polymerase chain reaction for B burgdorferi DNA is often positive before treatment, but is not a reliable marker of spirochetal eradication after therapy. This article reviews the clinical manifestations, diagnosis, and management of Lyme arthritis.

Keywords: Antibiotic-refractory arthritis; Borrelia burgdorferi; Inflammatory arthritis; Lyme arthritis; Lyme disease.

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Figures

Figure 1
Figure 1
Lyme arthritis. A swollen knee of a patient with Lyme arthritis is shown. Patients have intermittent or persistent attacks of joint swelling and pain, primarily in one or a few large joints, especially the knee, during a period of several years, with few systemic manifestations.
Figure 2
Figure 2
Algorithm for the diagnosis and treatment of Lyme arthritis. EM = erythema migrans; ELISA = enzyme-linked immunosorbant assay; PCR = polymerase chain reaction; IDSA = Infectious Disease Society of America; IV= intravenous; NSAID = nonsteroidal antinflammatory drug; DMARDs = disease modifying anti-rheumatic drugs
See this image and copyright information in PMC

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References

    1. Steere AC, Malawista SE, Snydman DR, et al. Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities. Arthritis Rheum. 1977;20(1):7–17. - PubMed
    1. Steere AC, Malawista SE, Hardin JA, et al. Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum. Ann Intern Med. 1977;86(6):685–98. - PubMed
    1. Steere AC, Schoen RT, Taylor E. The clinical evolution of Lyme arthritis. Ann Intern Med. 1987;107(5):725–31. *Key article, doi:10.7326/0003-4819-107-5-725. - PubMed
    1. Bacon RM, Kugeler KJ, Mead PS, Centers for Disease Control and Prevention (CDC) Surveillance for Lyme disease--United States, 1992-2006. MMWR Surveill Summ. 2008;57(10):1–9. - PubMed
    1. CDC estimates of Americans diagnosed with Lyme disease each year Press release from the Centers for Disease Control and Prevention. 2013 Aug 13; ( http://www.cdc.gov/media/releases/2013/p0819-lyme-disease.html)

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