The clinical evolution of Lyme arthritis.
To determine the clinical evolution of Lyme arthritis, 55 patients who did not receive antibiotic therapy for erythema chronicum migrans were followed longitudinally for a mean duration of 6 years. Of the 55 patients, 11 (20%) had no subsequent manifestations of Lyme disease. From 1 day to 8 weeks after disease onset, 10 of the patients (18%) began to have brief episodes of joint, periarticular, or musculoskeletal pain for as long as 6 years, but they never developed objective joint abnormalities. From 4 days to 2 years after disease onset, 28 (51%) had one episode or began to have intermittent attacks of frank arthritis, primarily in large joints; a few had polyarticular movement. The total number of these patients who continued to have recurrences decreased by 10% to 20% each year. The remaining 6 patients (11%) developed chronic synovitis later in the illness; of these, 2 (4%) had erosions, and 1 (2%), permanent joint disability. The spectrum of Lyme arthritis ranges from subjective joint pain, to intermittent attacks of arthritis, to chronic erosive disease.
Steere
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AC
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
Schoen
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Taylor
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D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003237:Connecticut; D004890:Erythema / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology; D008193:Lyme Disease / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D011159:Population Surveillance; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
D000900:Anti-Bacterial Agents