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Lyme arthritis appears not to be a rare manifestation of Borrelia burgdorferi infection in Germany. We report 20 cases of the illness occurring in South Germany. In eleven of our patients arthritis was the only clinical manifestation of the infection; the diagnosis in those cases has only been verified by the detection of specific antibodies to Borrelia burgdorferi with indirect immunofluorescence and IgG Western blot technique. In comparison with previous reports of
Lyme arthritis the quota of chronic joint involvement in our patients was relatively high, 4 of the patients developed radiographic signs of erosive arthritis. We suggest that
Lyme arthritis is still underrecognized in Germany, and that previously reported assertions concerning the relative frequency of the various
disease manifestations of Borrelia burgdorferi infections reflect a patient-selection.