Lyme Arthritis Program

About the program

A pioneer in Lyme disease

Our program is recognized internationally for its expertise in Lyme disease. Researchers affiliated with the program played a key role in identifying Lyme disease in 1976 and advancing understanding of its many manifestations, including Lyme arthritis.

Today, our team continues to investigate why some patients with Lyme arthritis experience persistent joint inflammation after antibiotic treatment has eliminated the Lyme disease bacterium. This research is helping improve diagnosis and treatment for patients with these complex conditions.

Part of Rheumatology, Inflammation, and Immunity

What to expect

Prior to your first appointment, one of our rheumatologists will review your records, particularly previous Lyme testing. Based on this evaluation, you will either be scheduled for a formal appointment, or referred to one of our colleagues in Neurology, Infectious Disease, or another appropriate specialist for the best care available for your specific case.

At your first appointment, one of our rheumatologists will review your history, perform a physical examination and decide which tests are necessary for diagnostic purposes.

Many symptoms of Lyme disease can be seen in other conditions. Our physicians' experience with Lyme disease—and the diagnostic tests we have developed—help us recognize that infection or differentiate it from other diseases, and if Lyme disease, determine what stage it is in. We treat patients according to the Infectious Disease Society of America guidelines.

Most patients with Lyme disease respond well to a three-to-four-week course of oral antibiotics (e.g. doxycycline or amoxicillin). Patients who do not have symptoms early in the infection or are not treated for early-stage Lyme disease may develop organ-system involvement of the infection.

Some patients who develop Lyme arthritis may require antibiotic therapy delivered intravenously. In these cases, a peripherally inserted central catheter (PICC line) will be placed in your arm and the initial infusion administered in the Rheumatology Unit's Infusion Center. Our experience in coordinating home infusion care will probably allow you to receive the remaining course of antibiotics in the comfort of your home rather than in the hospital.

In a small percentage of cases, Lyme arthritis persists after oral and intravenous antibiotics have apparently eliminated the bacterium. This complication is thought to result from the development of autoimmunity in affected joints. After appropriate antibiotic therapy, we treat these patients with anti-inflammatory medications or disease-modifying antirheumatic drugs.

Mass General Brigham's multidisciplinary approach

Multidisciplinary collaboration, a major strength at Mass General Brigham, is crucial in caring for patients with organ-system involvement of Lyme disease, particularly if there is neurologic or heart involvement. Whenever necessary, we involve other world-class specialists at the hospital to manage the various complications of the illness.

Treating Lyme disease, primarily Lyme arthritis

Lyme disease, a multistage bacterial infection, is caused by a spiral-shaped bacterium transmitted by a tick bite. The condition has a wide range of signs and symptoms that can affect many different body parts, particularly the skin, joints, nervous system or heart. Tests are required to diagnose Lyme disease by detecting the presence of a specific antibody or in some cases, the organism itself.

In most cases, we can effectively treat early-stage Lyme disease with a three-to-four-week course of oral antibiotics. However, if early-stage Lyme disease is asymptomatic or goes untreated, the patient may develop late-stage complications, most commonly Lyme arthritis.

Our program is highly skilled in treating Lyme arthritis and the many other manifestations of Lyme disease across all disease stages. We generally refer patients younger than 12 years of age to the pediatric rheumatologists at Mass General Brigham for Children.