Pathogenesis, Diagnosis and Treatment of Lyme Arthritis

Abstract

Lyme arthritis was recognised as a new nosological entity in 1975 because of geographic clustering of the disease in children in Lyme, Connecticut, who were thought to have juvenile rheumatoid arthritis (1). Joint disease in these children was characterised by brief, recurrent attacks of asymmetric swelling and pain in a few large joints, especially the knee. It then became apparent that Lyme arthritis was part of a multisystem illness that usually began with a characteristic annular skin lesion, erythema migrans (2). This skin lesion had been described previously in Europe, but it had not been associated there with arthritis.