How Rheumatology Specialists Help Kids Thrive

April 13, 2023

University Hospitals Rainbow Babies & Children'sExperts in Children's Health

A child playing with his mother in a public park

Adults and seniors are not the only ones who suffer with rheumatic diseases. Nearly 300,000 children in the United States are coping with arthritis and other rheumatic conditions that cause inflammation and other uncomfortable symptoms.

“The outlook for kids with rheumatic diseases has improved dramatically over the past decade,” says Omkar Phadke, MD, pediatric rheumatologist at University Hospitals Rainbow Babies & Children’s. “There are several effective medications available that help kids live more normal lives.”

What Are Rheumatic Diseases?

Rheumatic diseases are a group of autoimmune, inflammatory and bone disorders that affect the musculoskeletal system — the joints, bones, muscles and tendons that help the body move. Arthritis is one type of rheumatic disease. The causes of these diseases are unknown.

The most common symptoms are inflammation, swelling, pain and redness in the joints. Some conditions cause inflammation in the connective tissue, organs or blood vessels. Children also may experience fevers, rashes, painful and swollen glands, fatigue and sleep problems. In severe cases, rheumatic diseases can lead to permanent joint and tissue damage.

“Some children have one episode and do not require intensive long-term treatment with medication,” says Dr. Phadke. “Others have frequent flare-ups and need ongoing medical attention throughout their lives. Symptoms may change over time, and some children may have multiple rheumatic conditions.”

Common Rheumatic Diseases

Some of the most common rheumatic diseases affecting children include:

Juvenile idiopathic arthritis (JIA). Formerly known as juvenile rheumatoid arthritis, JIA is the most common type of arthritis in children. It causes joint pain, swelling and stiffness. There are several JIA subtypes, including: pauciarticular (which affects four or fewer joints); polyarticular (which affect five or more joints); systemic onset (which affects one or more joints and causes inflammation of the internal organs); juvenile ankylosing spondylitis (inflammation of the spine and hip); and juvenile psoriatic arthritis (joint inflammation that occurs in children with psoriasis).
Systemic lupus erythematosus. This disease occurs when the immune system malfunctions and attacks the body. Patients may develop inflammation in the skin, joints and organs.
Juvenile dermatomyositis. Children with this condition experience rashes and muscle weakness.
Mixed connective tissue disease. This rare autoimmune disorder combines features of several diseases, including: lupus, scleroderma, polymyositis and JIA. It may affect the fat, cartilage and other substances that connect and support the body.
Spondyloarthropathy. A type of arthritis that causes inflammation in the spine.
Vasculitis. A condition characterized by inflammation of the blood vessels.

A Team Approach

“Most kids who receive the right treatment do very well,” Dr. Phadke says. “They are able to participate in sports and other activities that their friends do.”

Diagnosis may include performing a physical exam, taking a complete medical history and ordering lab tests and x-rays. Team members then develop a comprehensive treatment plan for each patient that may include: one or more medications to control inflammation, pain and other symptoms; physical therapy; and counseling.

“Our pediatric experts collaborate with adult rheumatologists at University Hospitals,” notes Dr. Phadke. “That means children can stay with the same UH rheumatology team when they reach adulthood and are transitioned to adult rheumatology physicians.”