Pediatric Rheumatology at MCAM offers comprehensive assessment and treatment for children and adolescents with possible or confirmed rheumatic diseases.
Rheumatic diseases are rare and often complex. They may involve inflammation of joints, muscles, and sometimes the skin, the eyes or inner organs. Rheumatic disease symptoms may include joint pain and swelling, fever and/or a rash. Kids of all age groups can be affected. We often don’t know a definite cause of a rheumatic disease, but we assume today that most rheumatic diseases develop from autoimmune disorders—when our immune system mistakenly attacks parts of our own body.
The pediatric rheumatologist will diagnose your child’s particular condition. Treatment of rheumatic diseases is often complex and needs to consider all body parts that are involved. Therefore, your child’s rheumatologist may build a team together with you and your child to manage your child’s particular condition. The team members will depend on the needs of your child and may consist of a nurse, a pharmacist, a physical therapist, a social worker, a psychologist, and sometimes other pediatric subspecialists.
What do we diagnose and treat?
We provide diagnosis and treatment for conditions including but not limited to the following:
Juvenile idiopathic arthritis
Arthritis means the inflammation of the joint; symptoms include swelling, limitation in range of motion of the joint and often but not always pain. One joint, such as the knee, or many joints can be affected. The inflammation can last weeks and even months if the child does not receive treatment. The most common form of arthritis in children and adolescents under the age of 16 years is juvenile idiopathic arthritis (JIA). Idiopathic means that there is no other definite cause such as an infection underlying the arthritis. Please find further information here.
Systemic Lupus Erythematosus
In Systemic Lupus erythematosus (SLE), the immune system mistakenly may attack many different parts of the body such as joints, the skin, blood vessels or inner organs. SLE may develop over a long period of time and can look different from person to person. It can be a challenging diagnosis in some individuals. Please find further information here.
In Juvenile Dermatomyositis (JDM), the immune system mistakenly attacks the skin and muscles. The resulting inflammation of the skin (dermatitis) may lead to rashes over the eyelids, elbows, knuckles or knees. The resulting inflammation of the muscles (myositis) can cause swelling and weakness of the muscles and it may become difficult for the child to move around. Please find further information here.
Vasculitis is the inflammation of blood vessels. The walls of inflamed blood vessels may become leaky, causing some bleeding into the tissue; over time they may become thickened. When the walls become thickened, the blood flow to tissues and organs may become impaired, which may impact the function of the organs. There are many different types of vasculitis. Most of them are rare. Signs and symptoms of vasculitis depend on the affected blood vessels and the organs they supply with blood. Some forms don’t have serious consequences and don’t even need treatment. Some are more harmful and may require long-standing treatment. Please find further information here.
Small blood vessels that supply blood to the skin may become narrow in response to cold temperatures or stress. The skin of the fingers and toes, and sometimes of the nose tip, ears or lips may change colors from white to blue and may be painful or feel numb. When the skin becomes warm again, the color may change to red and the area may tingle. Raynaud’s phenomenon affects many healthy people and often does not require medical treatment other than protecting affected areas from cold exposure. Sometimes Raynaud’s phenomenon is part of an underlying disorder such as an autoimmune disease or can develop when taking particular medications. Please find further information here.
Fever of unknown origin and autoinflammatory syndromes
Fever is defined as a temporary raise of the body temperature to 100.4 to 101.3 Fahrenheit (38 to 38.5 °C) or higher. Fever is a symptom of many diseases and conditions. Sometimes when fever recurs daily for a longer period such as 2 weeks a rheumatic disease may be the cause. Sometimes fever recurs periodically over months or even years without a clear source. This type of fever may be part of a periodic fever syndrome. Periodic fever syndromes can be inherited, with more than one family member affected, or they can occur without a known genetic background.
Some infections can cause symptoms of rheumatic diseases. For instance, a pathogen can directly infect a joint. The resulting inflammation can lead to swelling and often severe pain in the joint (septic arthritis). In other circumstances, an infection can cause the immune system to mistakenly attack not only the infectious agent but also other parts of the body. As an example, the immune system first fights diarrhea and several days after recovery the child develops inflammation of one or several joints with swelling and pain.
Scleroderma is a group of rare diseases that goes along with hardening and thickening of the skin and possibly inner organs. In localized scleroderma, only the skin will be affected. In systemic scleroderma, the condition may affect the skin, blood vessels, and inner organs. Please find further information here.
Growing pain typically affects children between the ages of 3 and 12 years and usually impacts alternating the right and the left leg. The pain occurs at night after an active day and the child may wake up from the pain. Massaging the leg, children’s acetaminophen or children’s ibuprofen may help. The cause of growing pain is not clear, but the condition usually does not lead to long-term pain.
Joint hypermobility syndromes
Joint flexibility depends on the elasticity or stretchability of ligaments and tendons. Some populations have more flexible joints than others. In some circumstances, children develop joint pain without any inflammation when their joints are extremely loose and flexible. Please find further information here.
What can you expect at the first visit?
The pediatric rheumatologist will take the history of your child and will perform a thorough physical exam. Other members of the rheumatology team, such as a nurse or social worker, may see your child as well. Often further diagnostic procedures, including blood tests, may be performed before a diagnosis can be made. Sometimes it may take more than one visit to find out a diagnosis. Please be prepared that your child’s first visit may take 2 hours or longer.
How can you prepare for the visit?
- Please bring all medical information you have about your child, such as your own notes, your doctor’s notes, x-ray reports, and blood test results.
- Please bring all medications your child takes.
- If you would like, please write down all the questions you and your child have prior to your visit, so that they are easy to remember, and we can discuss them during your appointment.
- Please find here a short video on how to prepare your child for a possible needle poke, in case blood work needs to be performed.
- Please bring shorts and a T-shirt for your child; the physical exam will be easier and more comfortable for your doctor and your child.