Lyme arthritis

60% get brief attacks of arthritis, and oligoarticular arthritis usually of the large joints, particularly the knee, may occur there can be migratory joint or muscle pain, with or without joint swelling (1)

• may occur three to six months after infection (2)
• in contrast to other causes of septic arthritis
  • usually is less painful and not accompanied by fever
• often patients do not report a preceding tick bite or erythema migrans
• if untreated, symptoms include intermittent or persistent joint swelling and pain during a period of months to several years
• with appropriate antimicrobial therapy
  • the arthritis is cured and Borrelia is eradicated in most patients
  • however occasionally a proliferative synovitis may persist for months or several years, requiring anti-inflammatory therapy

Reference:

• Bratton R.L. et al. Diagnosis and treatment of Lyme disease. Mayo Clin Proc. 2008;83(5):566-71
• Kullber BJ et al. Lyme borreliosis: diagnosis and management.BMJ 2020;369:m1041