Pediatric Rheumatology services

What does a Pediatric Rheumatologist do?

Joint pains or arthritis

Its very common for children to get joint pains which maybe due to growing pains, sedentary lifestyle, obesity or hypermobility. These are known as biomechanical pains which usually needs symptomatic treatment and muscle strengthening. The other causes of joint pains are childhood arthritis also known as Juvenile Idiopathic Arthritis (JIA) which can be of many types and needs timely referral for diagnosis and  proper management. The rheumatologist may also first want to rule out other causes of joint swellings such as infections (septic arthritis or TB) or reactive arthritis.
Common symptoms are fevers, rashes, joint swellings, early morning stiffness, raised inflammatory markers on blood tests.

Autoimmune diseases

These can be broadly divided into connective tissue diseases (CTD) or childhood vasculitis. The common CTDs are – SLE (Lupus), Juvenile Dermatomyositis (JDM), Scleroderma, Mixed connective tissue disease (MCTD) or Overlap syndromes and Sarcoidosis. Vasculitis on the other hand can be broadly divided into small, medium and large vessel and the common ones include Kawasaki disease, IgA vasculitis (HSP), Polyarteritis nodosa (PAN), Takayasu arteritis or ANCA associated vasculitis. Other causes are inflammatory bowel disease associated arthritis and inflammation in the eye (Uveitis)
Common symptoms are frequent mouth or genital ulcers, excessive hairfall, rashes on the face and body, fingers or toes turning blue in cold, muscle weakness, joint swellings, tight shiny areas of skin, abdominal pains, blood in stools or red eyes.

Recurrent or Persisting fevers

Pyrexia of unknown origin (prolonged fevers) often needs inputs from the rheumatologist to look for inflammatory causes of fevers. Other causes such as genetic Systemic Autoinflammatory Diseases(SAID)  for recurrent fevers and Primary immunodeficiency (PID) also needs to be kept in the differential diagnosis of a child with multiple fever episodes with infections since an early age.