Rheumatic Conditions

Rheumatic conditions include a broad range of diseases that cause pain, stiffness and swelling in the joints. Some also involve internal organs, connective tissues, the immune system and other areas of the body. Rheumatic conditions usually involve abnormalities of the immune system. One of the most prevalent and well-known rheumatic conditions is juvenile rheumatoid arthritis (JRA). JRA and other rheumatic conditions affect approximately 300,000 children in the United States.

Our Team Approach

Gillette’s Center for Pediatric Rheumatology provides treatment to minimize pain, prevent joint inflammation and maintain range of motion in children who have juvenile rheumatoid arthritis and other rheumatic conditions. Our medical specialists work closely with patients and families to determine the most effective treatments, monitor progress and minimize complications. We help patients develop physically and emotionally while learning to manage their disease.

Cause

Typically, the immune system protects the body from infections, including bacteria and viruses. When the immune system loses its ability to distinguish normal parts of the body (such as cartilage) from infections, the body might damage its own joints and tissues. This results in painful inflammation and difficulty with joint movement. Genetics, trauma, infection, excessive stress on joints and metabolic disturbances can aggravate a rheumatic disease.

Diagnosis

Signs of rheumatic conditions vary widely, making diagnosis difficult. Symptoms might include joint swelling, loss of motion, painful motion, unusual joint warmth, limping, low appetite, fatigue, unusual rashes, fevers and delayed motor skills.

Following diagnosis, health effects of rheumatic diseases are similarly varied:

Joint Inflammation

Many children develop inflamed joints, causing warmth, swelling or stiffness. Inflammation causes fluid to accumulate in joints, which thickens joint lining. As a patient uses a joint less often, the tendons can stiffen and cause joint contractures.

Abnormal Bone and Muscle Development

Because inflammation sometimes alters the speed at which bones grow, it can cause leg length discrepancies and wasting muscles. Abnormalities of bone and muscle development can affect gait, causing a child additional frustration or decreasing their ability to participate in social activities.

Related Complications

Other complications, such as eye inflammation and temporomandibular joint arthritis (TMJ), can cause lifelong disabilities if untreated.

Treatment

Treatment can reduce symptoms and minimize complications of rheumatic conditions, allowing children to comfortably participate in everyday activities. Anti-inflammatory and/or immune-suppressive medications effectively reduce inflammation and prevent the immune system’s damage to joints and tissues. Physical and occupational therapy can prevent joint damage and help maintain range of motion.

Other treatments include:

• Shoe inserts, orthoses (braces) or splints to support joints and prevent misalignment
• Relaxation techniques to control pain
• Massage to increase blood flow and warm the muscles surrounding the joints
• Exercise to reduce joint pain and stiffness, and to maintain healthy weight
• Surgery (used in rare cases) to release tissue causing joint contractures or remove inflamed tissue from joint linings

Types

Juvenile Rheumatoid Arthritis

Spondyloarthropathy Syndromes

• Enthesitis Arthritis Syndrome
• Reactive Arthritis (Reiter’s Syndrome)
• Psoriatic Arthritis

Connective Tissue Conditions

• Systemic Lupus Erythematosus (SLE, lupus)
• Dermatomyositis
• Vasculitis
• Scleroderma
• Mixed Connective Tissue Disease (MCTD)
• Raynaud’s Phenomenon
• Sjögren’s Syndrome

Noninflammatory Disorders

• Benign Hypermobility Syndromes
• Growing Pains
• Infection-related Arthritis, including Lyme disease
• Reflex Sympathetic Dystrophy (Complex Regional Pain Syndrome)

Web Resources

KidsHealth – For Parents

http://www.kidshealth.org/parent/medical/arthritis/jra.html

KidsHealth – For Kids

http://kidshealth.org/kid/health_problems/bone/juv_rheum_arthritis.html

Information and Referrals

For more information about JRA, call the Center for Pediatric Rheumatology at 651-229-3893 or 800-719-4040 (toll-free). To refer a patient, call 651-229-3892. To schedule an appointment for a new patient, call 651-290-8707.