Lyme Arthritis: An Update for Clinical Practice

Area of Science:

• Infectious Diseases
• Rheumatology
• Public Health

Background:

• Lyme disease is North America's most common vector-borne illness, prevalent in the Northeast and upper Midwest.
• Lyme arthritis is the most frequent manifestation of late-stage Lyme disease.
• This arthritis typically affects large joints, often presenting as monoarthritis or oligoarthritis, particularly in the knee.

Purpose of the Study:

• To summarize the key aspects of Lyme arthritis, including its presentation, diagnosis, and initial treatment.
• To highlight Lyme arthritis as a significant clinical manifestation of Lyme disease.

Main Methods:

• Review of clinical presentation of Lyme arthritis.
• Summary of diagnostic criteria for Lyme arthritis.
• Overview of established initial treatment protocols for Lyme arthritis.

Main Results:

• Lyme arthritis commonly affects large joints, especially the knee.
• Diagnostic confirmation relies on positive 2-tier Lyme serologies or polymerase chain reaction (PCR) from synovial fluid/tissue in endemic areas.
• Initial management typically involves an extended course of oral antibiotics.

Conclusions:

• Lyme arthritis is a well-defined clinical entity in late-stage Lyme disease.
• Accurate diagnosis in endemic regions is crucial for timely and effective treatment.
• Oral antibiotic therapy remains the cornerstone of initial Lyme arthritis management.