title: Diagnosis and treatment of Lyme arthritis.
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.
authors.affiliation: Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Sheila L
authors.initials: SL
authors.lastname: Arvikar
authors.affiliation: Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: asteere@mgh.harvard.edu.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Steere
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D025065:Borrelia burgdorferi / Q000302:isolation & purification; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016133:Polymerase Chain Reaction; D013582:Synovial Fluid; D013585:Synovitis / Q000188:drug therapy / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents
keywords: Antibiotic-refractory arthritis; Borrelia burgdorferi; Inflammatory arthritis; Lyme arthritis; Lyme disease