{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:36Z","timestamp":1787755416962,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Cases:<\/jats:title>\n                    <jats:p>Three patients presented with bilateral knee pain, effusion, decreased range of motion, and difficulty ambulating. Synovial analysis demonstrated leukocytosis in bilateral knees with positive serum enzyme-linked immunosorbent assay. All cases were managed with antibiotics and anti-inflammatories. One patient developed chronic Lyme arthritis and underwent arthroscopic synovectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Bilateral knee arthritis is a possible presentation of Lyme disease in children. Accurate diagnosis and treatment with antibiotics and anti-inflammatories can lead to satisfactory outcomes. Arthroscopic synovectomy may be indicated if conservative treatment fails.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.22.00719","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T14:01:39Z","timestamp":1683900099000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Bilateral Knee Lyme Arthritis in Children"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7876-7568","authenticated-orcid":false,"given":"Thomas A.","family":"Gagliardi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5056-6780","authenticated-orcid":false,"given":"Avinesh","family":"Agarwalla","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3208-4301","authenticated-orcid":false,"given":"Philip K.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5185-0713","authenticated-orcid":false,"given":"Jennifer","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damon A.","family":"DelBello","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4]]},"reference":[{"issue":"2","key":"bib1-20240731","doi-asserted-by":"crossref","first-page":"616","DOI":"10.3201\/eid2702.202731","article-title":"Estimating the frequency of Lyme disease diagnoses, United States, 2010-2018","volume":"27","author":"Kugeler","year":"2021","journal-title":"Emerg Infect Dis."},{"issue":"2","key":"bib2-20240731","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":"Arvikar","year":"2015","journal-title":"Infect Dis Clin North Am."},{"issue":"22","key":"bib3-20240731","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss6622a1","article-title":"Surveillance for Lyme disease\u2014United States, 2008-2015","volume":"66","author":"Schwartz","year":"2017","journal-title":"MMWR Surveill Summ."},{"issue":"3","key":"bib4-20240731","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1093\/cid\/ciy510","article-title":"Insights from the geographic spread of the Lyme disease epidemic","volume":"68","author":"Eddens","year":"2019","journal-title":"Clin Infect Dis."},{"issue":"3","key":"bib5-20240731","doi-asserted-by":"crossref","first-page":"252","DOI":"10.2106\/JBJS.I.01776","article-title":"Lyme arthritis in children presenting with joint effusions","volume":"93","author":"Milewski","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"12","key":"bib6-20240731","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1002\/acr.22086","article-title":"Lyme arthritis: a comparison of presentation, synovial fluid analysis, and treatment course in children and adults","volume":"65","author":"Daikh","year":"2013","journal-title":"Arthritis Care Res (Hoboken)."},{"issue":"1","key":"bib7-20240731","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/PEC.0000000000000028","article-title":"Synovial fluid findings in children with knee monoarthritis in Lyme disease endemic areas","volume":"30","author":"Deanehan","year":"2014","journal-title":"Pediatr Emerg Care."},{"issue":"2","key":"bib8-20240731","doi-asserted-by":"crossref","first-page":"91","DOI":"10.5435\/00124635-201102000-00004","article-title":"Lyme disease and the orthopaedic implications of Lyme arthritis","volume":"19","author":"Smith","year":"2011","journal-title":"J Am Acad Orthop Surg."},{"issue":"5","key":"bib9-20240731","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.3899\/jrheum.090711","article-title":"Outcomes of children treated for Lyme arthritis: results of a large pediatric cohort","volume":"37","author":"Tory","year":"2010","journal-title":"J Rheumatol."},{"issue":"3","key":"bib10-20240731","doi-asserted-by":"crossref","first-page":"e695","DOI":"10.1542\/peds.2012-2531","article-title":"Distinguishing Lyme from septic knee monoarthritis in Lyme disease-endemic areas","volume":"131","author":"Deanehan","year":"2013","journal-title":"Pediatrics."},{"issue":"2","key":"bib11-20240731","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/nri1267","article-title":"Elucidation of Lyme arthritis","volume":"4","author":"Steere","year":"2004","journal-title":"Nat Rev Immunol."},{"issue":"6","key":"bib12-20240731","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1002\/art.1780370616","article-title":"Treatment of Lyme arthritis","volume":"37","author":"Steere","year":"1994","journal-title":"Arthritis Rheum."},{"issue":"8596","key":"bib13-20240731","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S0140-6736(88)92011-9","article-title":"Treatment of late Lyme borreliosis: randomised comparison of ceftriaxone and penicillin","volume":"331","author":"Dattwyler","year":"1988","journal-title":"Lancet."},{"issue":"8","key":"bib14-20240731","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1002\/art.1780340817","article-title":"Treatment of refractory chronic Lyme arthritis with arthroscopic synovectomy","volume":"34","author":"Schoen","year":"1991","journal-title":"Arthritis Rheum."},{"key":"bib15-20240731","first-page":"018","article-title":"Acute Lyme arthritis presenting in bilateral hips of an elderly patient: a case report","volume":"5","author":"Asprec","year":"2019","journal-title":"Int J Physiatry."},{"issue":"4","key":"bib16-20240731","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s11832-014-0602-3","article-title":"Lyme arthritis of the pediatric lower extremity in the setting of polyarticular disease","volume":"8","author":"Aiyer","year":"2014","journal-title":"J Child Orthop."},{"issue":"1","key":"bib17-20240731","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12969-017-0166-0","article-title":"When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease\u2014a review of Lyme arthritis in children","volume":"15","author":"Orczyk","year":"2017","journal-title":"Pediatr Rheumatol Online J."},{"issue":"9","key":"bib18-20240731","doi-asserted-by":"crossref","first-page":"721","DOI":"10.2106\/JBJS.14.01331","article-title":"Predictive factors for differentiating between septic arthritis and Lyme disease of the knee in children","volume":"98","author":"Baldwin","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib20-20240731","doi-asserted-by":"crossref","first-page":"e911","DOI":"10.1097\/BPO.0000000000001959","article-title":"The impact of operative intervention in pediatric Lyme arthritis","volume":"41","author":"Tout","year":"2021","journal-title":"J Pediatr Orthop."},{"issue":"4","key":"bib21-20240731","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1084\/jem.20052471","article-title":"Antibiotic-refractory Lyme arthritis is associated with HLA-DR molecules that bind a Borrelia burgdorferi peptide","volume":"203","author":"Steere","year":"2006","journal-title":"J Exp Med."},{"issue":"5","key":"bib22-20240731","doi-asserted-by":"crossref","first-page":"725","DOI":"10.7326\/0003-4819-107-5-725","article-title":"The clinical evolution of Lyme arthritis","volume":"107","author":"Steere","year":"1987","journal-title":"Ann Intern Med."},{"issue":"1","key":"bib23-20240731","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/RHU.0000000000000615","article-title":"Medical versus surgical approach to initial treatment in septic arthritis","volume":"25","author":"Flores-Robles","year":"2019","journal-title":"J Clin Rheumatol."},{"issue":"7","key":"bib24-20240731","doi-asserted-by":"crossref","first-page":"2774","DOI":"10.1128\/iai.61.7.2774-2779.1993","article-title":"Association of treatment resistant chronic Lyme arthritis with HLA-DR4 and antibody reactivity to OspA and OspB of Borrelia burgdorferi","volume":"61","author":"Kalish","year":"1993","journal-title":"Infect Immun."},{"issue":"4","key":"bib25-20240731","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1056\/NEJM199007263230402","article-title":"Association of chronic Lyme arthritis with HLA-DR4 and HLA-DR2 alleles","volume":"323","author":"Steere","year":"1990","journal-title":"N Engl J Med."},{"issue":"7","key":"bib26-20240731","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/pch\/20.7.377","article-title":"Clinical characteristics, treatment and outcome of children with Lyme arthritis in Nova Scotia","volume":"20","author":"Glaude","year":"2015","journal-title":"Paediatr Child Health."},{"issue":"8","key":"bib27-20240731","doi-asserted-by":"crossref","first-page":"943","DOI":"10.3899\/jrheum.180775","article-title":"Pediatric antibiotic-refractory Lyme arthritis: a multicenter case-control study","volume":"46","author":"Horton","year":"2019","journal-title":"J Rheumatol."},{"issue":"4 pt 1","key":"bib28-20240731","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1542\/peds.102.4.905","article-title":"Lyme arthritis in children: clinical epidemiology and long-term outcomes","volume":"102","author":"Gerber","year":"1998","journal-title":"Pediatrics."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00719","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:42:42Z","timestamp":1787751762000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00719"}},"subtitle":["A Report of 3 Cases"],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.22.00719","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}