Dr. John Lambert:

I specifically quoted an article from Stricker et al. They studied patients two years down the way who had proven Lyme disease that was not treated and 70% of them had what was called "migratory arthritis", that is, arthritis that moved from one place to another. If one did not take the right history and did not think about a tick bite, one might diagnosis it as rheumatoid arthritis or other diseases. In fact, the first patient I saw in Ireland five years ago was from Connemara and he was diagnosed as having atypical rheumatoid arthritis. He was given methotrexate - nobody thought Lyme disease. The infection was disseminated. A year later, when he was critically unwell, they did an antibody test for Lyme disease and it was positive. That was my first patient. Some cases of arthritis are being misdiagnosed and Lyme disease is being missed.