The presentation is very different from early Lyme arthralgia. Symmetric polyarthritis is a rare finding. Lyme arthritis will appear weeks to as long as 2 years after inoculation. The disease can become chronic and intermittent, with attack of a few weeks to months and remissions. The intensity of the attacks decreases with time.
Fever is absent but fatigue is common.
If not treated properly, irreversible erosion of cartilage and bone will lead to permanent damage. Diagnosis of Lyme monoarthritis is sometimes viewed as extremely difficult. In fact, in most cases, laboratory findings are pretty obvious as described later in this review. The real problem is that Lyme arthritis has the same symptoms as rheumatoid arthritis and is often mistakenly treated as such. Today CNB probably remains the main Lyme diagnostic challenge for the clinician and for the laboratory.