A 3 year old male child with a swollen joint who eventually was diagnosed as hemophilia
“It is not a case we are treating; it is a living, palpitating, alas, too often suffering fellow creature.”
John Brown
[1810- 1882]
“The paths of the pain are thine. Go forth with healing and with hope.”
John Greenleaf Whittier
[1807- 1892]
To a young physician
Pediatric Rheumatology - Symptoms & Diseases
Symptoms
A pediatric rheumatologist evaluates and treats a variety of symptoms, including
- Arthritis
- Joint and limb pains, with or without swelling of the joints
- Backache
- Limping
- Prolonged fever, unexplained fever, or recurrent fever
- Unexplained complaints of weakness, poor appetite, fatigue, and/or loss of function or skills
- Unexplained symptoms such as hair fall, anemia, or weight loss
- Possible inflammatory disease
- Various types of skin rashes
- Recurrent mouth ulcers
- Multi-organ diseases that may involve the skin, kidneys, brain, or lungs
- Uveitis (a type of eye inflammation)
Pediatric rheumatologists may interact with or get referrals from other specialists such as general pediatricians, orthopaedic surgeons, pediatric ophthalmologists, nephrologists, physiotherapists, psychologists, or nutrition experts.
Diseases
The common diseases which come under the purview of a pediatric rheumatologist include
- Juvenile Idiopathic Arthritis (formerly known as juvenile rheumatoid arthritis)
- Systemic Lupus Erythematosus (SLE)
- Juvenile Dermatomyositis
- Vasculitis including Hennoch Schönlein purpura, Kawasaki Disease, polyarteritis nodosa etc
- Juvenile localized and systemic scleroderma
- Pain syndromes of childhood including growing pains and joint hypermobility
- Hereditary / genetic disorders of bone and connective tissue
- Infections of bones and joints such as Tuberculosis and septic arthritis /osteomyelitis
- Rheumatic fever and other post infective conditions
- Periodic fever syndromes (now known as auto-inflammatory syndromes) including juvenile and hereditary sarcoidosis (Blau syndrome), (DADA2 syndrome, CINCA, monogenic lupus amongst others
There are several other diseases which surprise doctors since their initial symptoms relate to bones and joints even though they belong to other specialties. Blood diseases such as leukemia, sickle cell disease or hemophilia and benign / malignant tumours of bones and joints, primary and secondary immunodeficiencies, drug side effects, vitamin deficiencies, poisonings and even psychiatric disorders in children may first present to the pediatric rheumatologist.