title: Lyme Disease Manifestations in the Foot and Ankle: A Retrospective Case Series.
abstract: Lyme disease is the result of Borrelia burgdorferi bacterial infection after exposure from a tick bite. A pathognomonic finding in early-stage Lyme disease is an expanding, red macular ring known as erythema migrans. Lyme arthritis is a late-stage manifestation of this disease, affecting the large, weightbearing joints with intermittent pain and swelling. The existing data on Lyme disease and subsequent arthritis have reported manifestations in the lower extremity, primarily in the knee and ankle and less commonly the small joints of the foot. We present a retrospective case series of 11 cases of painful arthritis in the foot and ankle with confirmatory Lyme disease testing.
authors.affiliation: Fellowship Director, Pennsylvania Intensive Lower Extremity Fellowship, Premier Orthopaedics and Sports Medicine, Malvern, PA.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Miller
authors.affiliation: Fellow, Pennsylvania Intensive Lower Extremity Fellowship, Premier Orthopaedics and Sports Medicine, Malvern, PA. Electronic address: dr.karldunn@gmail.com.
authors.forename: Karl W
authors.initials: KW
authors.lastname: Dunn
authors.affiliation: Private Practice, Harleysville, PA.
authors.forename: Domenick
authors.initials: D
authors.lastname: Braccia
authors.affiliation: Private Practice, Premier Orthopaedics and Sports Medicine, Malvern, PA.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Ciliberti
authors.affiliation: Resident, Bryn Mawr Hospital Podiatric Surgical Residency, Bryn Mawr, PA.
authors.forename: Dina K
authors.initials: DK
authors.lastname: Becker
authors.affiliation: Resident, Bryn Mawr Hospital Podiatric Surgical Residency, Bryn Mawr, PA.
authors.forename: Joshua K
authors.initials: JK
authors.lastname: Hollinger
authors.affiliation: Fourth-Year Podiatry Medical Student, Temple University School of Podiatric Medicine, Philadelphia, PA.
authors.forename: Shelley M
authors.initials: SM
authors.lastname: Brand
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D033023:Foot Joints / Q000382:microbiology*; D006801:Humans; D007592:Joint Diseases / Q000382:microbiology*; D008193:Lyme Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Borrelia; arthritis; infection; lower extremity; spirochete