{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:36:39Z","timestamp":1740148599555,"version":"3.37.3"},"reference-count":9,"publisher":"Georg Thieme Verlag KG","issue":"S 02","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Resumo<\/jats:title><jats:p>Na investiga\u00e7\u00e3o da monoartrite do joelho dever\u00e3o ser considerados v\u00e1rios diagn\u00f3sticos diferenciais. Relata-se o caso de uma doente com epis\u00f3dios recorrentes de derrame do joelho, em que a cl\u00ednica inespec\u00edfica implicou v\u00e1rias hip\u00f3teses diagn\u00f3sticas, imprecis\u00f5es terap\u00eauticas e um atraso na implementa\u00e7\u00e3o de terap\u00eautica adequada.<\/jats:p><jats:p>Durante mais de 2 anos, a doente foi avaliada em diferentes consultas de Ortopedia e Reumatologia. Realizou m\u00faltiplas terap\u00eauticas incluindo uma artroscopia do joelho com meniscectomia parcial, com melhoria transit\u00f3ria das queixas, contudo sem diagn\u00f3stico definitivo. Ap\u00f3s coleta de amostras de l\u00edquido sinovial com exames microbiol\u00f3gicos sucessivamente negativos, verificou-se uma sobreposi\u00e7\u00e3o de artrite s\u00e9ptica por microrganismos at\u00edpicos isolados no tecido sinovial (Pantoea spp. e Staphylococcus saprophyticus) e artrite de Lyme. Foi realizada lavagem e desbridamento cir\u00fargico, seguido de antibioterapia dirigida com resposta transit\u00f3ria, por infe\u00e7\u00e3o persistente (estadio 3).<\/jats:p><jats:p>O caso apresentado demonstra a necessidade de uma abordagem multidisciplinar da monoartrite do joelho.<\/jats:p>","DOI":"10.1055\/s-0043-1771487","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T22:51:50Z","timestamp":1713826310000},"page":"e149-e154","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Monoartrite persistente do joelho como apresenta\u00e7\u00e3o de doen\u00e7a de Lyme: Um desafio diagn\u00f3stico \u2013 Relato de caso"],"prefix":"10.1055","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6189-9334","authenticated-orcid":false,"given":"Rita","family":"Al\u00e7ada","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Ortopedia, Hospital de Cascais Dr. Jos\u00e9 de Almeida, Cascais, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-1438","authenticated-orcid":false,"given":"Nuno Pina","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Hospital Dr. N\u00e9lio Mendon\u00e7a, Funchal, Madeira, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7156-0369","authenticated-orcid":false,"given":"Rita","family":"Torres","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6796-0207","authenticated-orcid":false,"given":"Maria Helena","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8723-8350","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Flor de Lima","sequence":"additional","affiliation":[{"name":"Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6186-0229","authenticated-orcid":false,"given":"Francisco","family":"Guerra Pinto","sequence":"additional","affiliation":[{"name":"Hospital Ortop\u00e9dico de Sant'Ana, Parede, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.pop.2006.06.010","article-title":"Acute monarthritis: diagnosis and management","volume":"33","author":"E E Maury","year":"2006","journal-title":"Prim Care"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"30S","DOI":"10.1016\/S0002-9343(97)00414-2","article-title":"Monarthritis: differential diagnosis","volume":"102","author":"K Sack","year":"1997","journal-title":"Am J Med"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1503\/cmaj.080183","article-title":"Acute monoarthritis: what is the cause of my patient's painful swollen joint?","volume":"180","author":"L Ma","year":"2009","journal-title":"CMAJ"},{"issue":"01","key":"ref4","first-page":"83","article-title":"Diagnosing acute monoarthritis in adults: a practical approach for the family physician","volume":"68","author":"C Siva","year":"2003","journal-title":"Am Fam Physician"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.idc.2015.02.004","article-title":"Diagnosis and treatment of Lyme arthritis","volume":"29","author":"S L Arvikar","year":"2015","journal-title":"Infect Dis Clin North Am"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"674","DOI":"10.5435\/JAAOS-D-14-00388","article-title":"Lyme Disease Presenting as a Spontaneous Knee Effusion","volume":"23","author":"E Matzkin","year":"2015","journal-title":"J Am Acad Orthop Surg"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1038\/s41584-021-00648-5","article-title":"Lyme arthritis: linking infection, inflammation and autoimmunity","volume":"17","author":"R B Lochhead","year":"2021","journal-title":"Nat Rev Rheumatol"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"e540","DOI":"10.1097\/RHU.0000000000001513","article-title":"Stages of Lyme Arthritis","volume":"27","author":"J B Miller","year":"2021","journal-title":"J Clin Rheumatol"},{"volume-title":"Mandell. 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