&Lyme arthritis=Osteoarthritis, also known as degenerative arthritis, is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more joints. Osteoarthritis tends to be asymmetric in pattern. The most frequently affected sites are the DIP and PIP joints of the hand, the base of the thumb (CMC joint), the apophyseal joints of the cervical and lumbar spine, the first MTP as well as the knee and hip. Patients often complain of pain (which is typically exacerbated by activity and relieved by rest), stiffness after inactivity lasting a few minutes (gelling), "popping" of joints (felt as crepitus on exam) and functional limitation. It is characterized on physical exam by joint line tenderness, bony hypertrophy (Heberden's nodes at DIPs and Bouchard's nodes at PIPs),  and restricted range of motion. X-rays may show joint space narrowing, cystic changes, osteophytes and sclerosis.