What diagnostic test is commonly used for Lyme disease confirmation?

Blood serology tests are commonly used for the confirmation of Lyme disease because they detect antibodies produced in response to the Borrelia burgdorferi infection, the bacterium that causes the disease. In the early stages of Lyme disease, specific antibodies (IgM and IgG) may be present in the bloodstream. The most widely accepted tests are enzyme-linked immunosorbent assays (ELISA) followed by a Western blot for confirmation when results are positive or indeterminate. This two-step testing approach helps to improve accuracy and reduce false positives, making it essential for diagnosing Lyme disease effectively.

Other tests listed are not appropriate for confirming Lyme disease; for example, skin biopsy may be useful to detect Lyme borreliosis in certain atypical presentations, but it is not a standard diagnostic tool for Lyme disease. X-ray imaging is useful for assessing joint complications possibly related to Lyme disease but does not confirm the infection itself. Urinalysis is not relevant for the diagnosis of Lyme disease since the infection is not detected in urine. Thus, the serology test stands out as the primary method for confirming Lyme disease due to its ability to detect the immune response to the pathogen.