Pediatric rheumatology

• Juvenileidiopathic arthritis.
• Juvenilespondyloarthropathy .
• Psoriatic arthritis.
• Localized and systemicscleroderma .
• Raynaud's phenomenon.
• Systemiclupus erythematosus .
• Juveniledermatomyositis .
• Recurrent fevers and autoinflammatory syndromes (e.g., Familial Mediterranean Fever, CINCA/NOMID syndrome, TRAPS syndrome, Hyper IgD/MKD syndrome, etc.).
• Acute osteomyelitis and septic arthritis.
• Chronic multifocalosteomyelitis.
• Rheumatic fever and parainfective arthritis.
• Vasculitis (e.g. Kawasaki syndrome, Schoenlein Henoch purpura, panarteritis nodosa).

Diagnosis

The diagnosis of rheumatologic diseases is made by starting with a clinical evaluation in which the information and clinical elements that led the child to the specialist are gathered. It is important, during the clinical examination, to involve the child as well, since from a certain age he or she is able to participate actively both by answering specific questions and during and by cooperating with the objective joint examination.

The clinical evaluation can be complemented by other investigations, for example:

• Blood tests: tests that are strictly necessary (e.g., blood formula, organ function and autoantibodies) and oriented to further investigate the specific clinical question are performed.
• Instrumental examinations: radiological examinations (radiography, ultrasound, MRI) are proposed if necessary to further investigate.
• Other evaluations: in addition to the rheumatology examination, consultations with other specialists (e.g., ophthalmologist, orthopedist) are sometimes necessary.

Treatments

Therapy for the treatment of musculoskeletal disorders is mainly pharmacological and is based on:

• Oralnonsteroidal anti-inflammatory drugs (NSAIDs), which decrease joint stiffness and pain.
• Cortisone (glucocorticoids) by mouth or intravenously: these are used in selected cases and for very short periods to control inflammation.
• Cortisone (glucocorticoids) by intra-articular injection: these are very effective in rapidly controlling joint inflammation. Intra-articular injections can be given in multiple joints on the same occasion.
• Immunosuppressive drugs: depending on the diagnosis and if necessary, medium- to long-term immunosuppressive therapies are prescribed.