1) What is pediatric rheumatology?
Pediatric rheumatology is a sub-speciality of pediatrics which deals with children and adolescents having bone, joint, muscle and connective tissue diseases. Since several childhood diseases have musculoskeletal manifestations, another name for pediatric rheumatology is ‘musculoskeletal medicine’.
2) Why should I consult a pediatric rheumatologist for my child’s rheumatic disease?
A pediatric rheumatologist is a specialist pediatric doctor who evaluates and treats a variety of joint, muscle, and bone disorders. These can include:
3) When should I see a pediatric rheumatologist for my child?
Children with rheumatic disease can have varied clinical symptoms and should be taken to a pediatric rheumatologist when they exhibit:
Read more at When to see the Doctor?
4) How to make the most of life when my child has a rheumatic disease?
Any child who suffers from a rheumatic disease may have some limitations in his / her activity. A timely diagnosis and treatment of the underlying disease can reduce the complications and help the child lead a completely normal life like their peers. Some steps that can help the child are:
5) What to eat and what not to eat, in rheumatic diseases?
There is no evidence that a specific diet can influence the disease process. A child with a rheumatic disease should follow a balanced diet normal for his / her age. Overeating should be avoided in patients taking corticosteroids, as these drugs increase appetite. Food with high calories and sodium should be avoided during corticosteroid treatment, even if the child is taking a small dose.
Read more at Diet.
6) What are the risk factors / triggers that cause flares in rheumatic diseases?
Disease flares are known to happen with rheumatic diseases especially when there is tapering of medicines and a period of remission. No diet or specific foodstuff has been proven to cause a flare. Parents should keep in mind the following triggering factors that can cause flares:
7) Are exercises helpful for my child?
Yes. Exercise along with physical therapy is an important part of the child’s treatment plan. It enables the child to participate optimally in all daily activities of life and encourages active healthy living.
Exercise and physical therapy also help in achieving better joint mobility, joint stability, muscle flexibility, muscle strength, coordination and endurance (stamina). This helps the child safely engage in normal and extra-curricular school activities. However, it is important that this is done with the guidance of your doctor and physiotherapist, to avoid complications and trauma.
8) Do all patients with rheumatic disease require corticosteroids?
No. Many rheumatic diseases may require steroids for treatment, but not all. The duration of steroid treatment may be short or long-term. Usually started at a higher dose, the steroid dose is gradually reduced as per the individual patient, and may be stopped or continued for a long time in a small dose depending on the type of rheumatic disease.
Read more at Steroid Precautions.
9) What are biologic medicines?
New opportunities for treating rheumatic disease have become available in the last few years with substances known as biologic agents. These are drugs, produced through biological engineering, that are primarily directed against specific molecules (tumour necrosis factor or TNF, interleukin 1 or 6, T cell receptor antagonist) in the inflammatory pathway. Biologic agents have been shown to block the inflammatory process that is typical of Juvenile Idiopathic Arthritis and other rheumatic diseases. Biosimilars have been developed for several of these treatments so that after the expiry of the patent, similar drugs with a lower cost can be made available. Whenever such medicines are prescribed for your child, you should discuss the pros and cons with your treating doctor.