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Lyme arthritis of the pediatric ankle.

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Lyme arthritis results from acute inflammation caused by the spirochete Borrelia burgdorferi. The number of cases per year has been rising since 2006, with a majority of patients being affected in the northeastern United States. Development of
Lyme arthritis is of particular importance to the orthopedic surgeon because
Lyme arthritis often presents as an acute episode of joint swelling and tenderness and may be confused with bacterial septic arthritis. Considering the vast difference in treatment management between these 2 pathologies, differentiating between them is of critical importance. Septic arthritis often needs to be addressed surgically, whereas
Lyme arthritis can be treated with oral antibiotics alone. Laboratory testing for
Lyme disease often results in a delay in diagnosis because many laboratories batch-test
Lyme specimens only a few times per week because of increased expense. The authors present a case of
Lyme arthritis in the pediatric ankle in an endemic region. No clear algorithm exists to delineate between septic arthritis and
Lyme arthritis of the joint. Improved clinical guidelines for the identification and diagnosis of
Lyme arthritis of the ankle are important so that appropriate antibiotics can be used and surgery can be avoided.

Copyright 2014, SLACK Incorporated.

Orthopedics. 2014 Oct;37(10):e952-5. doi: 10.3928/01477447-20140924-94.

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