Lyme Arthritis

Stage:  “Late Lyme”  —  Occurs months-to-years after infection
  • Monoarticular / Oligoarticular (<5 joints)
  • Intermittent / Persistent
Joint Pattern
  • Knee extremely common
  • Shoulder, Ankle, Elbow, TMJ, Wrist
  • Joints more swollen & warm, less painful
Diagnosis:  IgG antibody to Borrelia burgdorferi
  • 100% sensitive
  • Poor specificity [high asymptomatic sero-prevalence in endemic area]
  • Positive AB & typical presentation warrants Tx
Persistent arthritis despite Tx:
  • B. burgdorferi DNA in synovial fluid (by PCR) suggests Tx failure
NOTE: “Early” & “Early Disseminated” stages may cause polyarthralgias
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