Department of Orthopaedics and Rehabilitation, Yale University School of Medicine and School of Public Health, New Haven, CT, USA.
J Am Acad Orthop Surg. 2011 Feb;19(2):91-100. doi: 10.5435/00124635-201102000-00004.
Lyme disease is the most common tick-borne disease in the United States and Europe. Increased awareness of the clinical manifestations of the disease is needed to improve detection and treatment. In the acute and late stages, Lyme disease may be difficult to distinguish from other disease processes. The epidemiology and pathophysiology of Lyme disease are directly related to the Borrelia burgdorferi spirochete and its effects on the integumentary, neurologic, cardiac, and musculoskeletal systems. Lyme arthritis is a common clinical manifestation of Lyme disease and should be considered in the evaluation of patients with monoarticular or pauciarticular joint complaints in a geographic area in which Lyme disease is endemic. Management of Lyme arthritis involves eradication of the spirochete with antibiotics. Generally, the prognosis is excellent. Arthroscopic synovectomy is reserved for refractory cases that do not respond to antibiotics.
莱姆病是美国和欧洲最常见的蜱传疾病。为了提高检出率和治疗效果，需要提高对该病临床表现的认识。在急性期和晚期，莱姆病可能难以与其他疾病过程相鉴别。莱姆病的流行病学和病理生理学与伯氏疏螺旋体直接相关，其对皮肤、神经、心脏和肌肉骨骼系统均有影响。莱姆关节炎是莱姆病的常见临床表现，在莱姆病流行地区，如果患者有关节单关节炎或少关节炎的主诉，应考虑莱姆关节炎。莱姆关节炎的治疗包括用抗生素清除螺旋体。一般来说，预后极好。如果抗生素治疗无效，关节镜滑膜切除术可作为难治性病例的保留治疗方法。
