Lyme disease
Lyme disease is an increasing cause of chronic arthritis, where there are attacks of inflammation lasting weeks, often separated by months without symptoms. The joint most commonly affected is the knee. It is caused by infection with a germ from the family called the spirochaetes (another member of which causes syphilis) caught from the bite of an insect called a tick. It's called Lyme disease because it was first diagnosed in a town called Lyme in Connecticut, but in fact it occurs throughout the world. Following the bite of the tick there is a spreading red rash from the site of the bite called erythema chronicum migrans (because it’s red, it lasts a long time and it spreads) which may not appear for up to a month, and other symptoms affecting the nervous system or the heart may also occur. Fever, muscle and joint pains together with a chronic spreading rash following an insect bite (even if you're not in Connecticut) needs investigation and treatment. It might be helpful to use insect repellent to prevent the bite in the first place.
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