If you have a child who has a
rheumatic disorder, it is imperative that you do thorough research before
choosing a doctor and following through with certain treatments. During a
consultation, keep in mind any questions or concerns of specific treatments, and
discuss each treatment thoroughly with the doctor to ensure that each treatment
is suitable for your child. There are resources, such as the Choosing Wisely
campaign, that can help make your decision more clear.
For the Choosing Wisely campaign, 35
medical specialty groups collaborated to help prevent further unnecessary
treatments for children who have rheumatic disorders. This campaign helps to
educate those who have rheumatic disorders, or those who have loved ones with
rheumatic disorders, about specific treatments, and what treatments are
necessary. The purpose of this campaign is to emphasize that all rheumatic
conditions are extremely complex; therefore, if you have a child with a
rheumatic disorder, it is vital to understand what your child has and what your
child needs. The journal, Arthritis Care
& Research, which has been recently published on the ACR's list,
includes tests and treatments recommended by rheumatologists that may be of
help to your child.
The doctor should conduct a thorough
medical history to determine whether or not the symptoms warrant specific
treatments. Once the history is noted, specific tests will be necessary to
determine a potential treatment. It is not wise to settle for one quick
diagnosis, as certain diseases, such as Lyme disease, can leave a false
positive for blood tests. If the child has inflammatory arthritis, request a
standard X-ray and activity assessments, as these are more cost effective. If a
doctor recommends an MRI it is not needed, it is unnecessary.
Many patients respond to standard
treatment; therefore, a trial of methotrexate or other conventional
non-biologic drugs must be conducted, which will then proceed with any biologic
drugs for rheumatoida arthritis. For a condition like osteoporosis, a screening
is done, known as the Dual-Energy X-ray Absorptiometry (DEXA). The scans must
not perform more often than once every two years.
Tests
and Procedures for pediatric patients
Your child's symptoms, medical
history, a comprehensive physical examination, and lab test results are the
basis of the diagnosis for a rheumatologic or immunologic disorder, such as:
●
Physicians need to examine your child's joint(s)
and other parts of his or her body. Imaging techniques, such as X-rays, CTscans, or MRIs allow for the examination, and are the most efficient techniques
of all.
●
Biopsies of select body organs.
●
The removal of fluids in certain areas of his or
her body.
After the diagnosis is reached, the
physician will recommend treatment plans specifically designed for your child.
In order to reduce pain and inflammation, in addition to recovering the joint
and other organ system functions, children are treated with physical and
occupational therapy, certain exercise, and oral and intravenous medications.
Joint
Aspirations and Injections
Excess and often inflamed fluid from
the affected joint is removed by a joint aspiration and injection procedure.
After that, an injection of a high potency corticosteroid is given to provide a
strong anti-inflammatory effect.
Medications that are given
intravenously include Infliximab (Remicade), Cyclophosphamide (Cytoxan) and Intravenous
Immunoglobulin (IVIG).
Contact your local rheumatologist
to discuss any of these treatments.
