INDICATIONS FOR THE REFERRAL
OF CHILDREN WITH RHEUMATIC DISEASE TO A PEDIATRIC RHEUMATOLOGIST
ALL
INFORMATION IS PROVIDED AS A PUBLIC SERVICE AND NO WARRANTY IS EXPRESSED OR IMPLIED.
This page is provided by Thomas J. A. Lehman MD
Delivering the
best care - with great care
Dr. Lehman is the
author of many textbook chapters and articles on the care of children and young
adults with rheumatic diseses. He practices in
Introduction:
The rheumatic diseases of childhood are an important
cause of both short and long term disability in childhood. Proper diagnosis and
early aggressive intervention can minimize both the short and long term
morbidity of these conditions, and thereby minimize the cost of caring for
these children. Without proper therapy acute rheumatic fever, systemic lupus
erythematosus, dermatomyositis, progressive systemic sclerosis, and many forms
of vasculitis may be fatal. Other conditions such as juvenile rheumatoid
arthritis and spondyloarthropathies do not threaten life, but may be associated
with a lifetime of chronic disability. All of the rheumatic diseases of
childhood may have profound effects on the physical and psychological growth of
the child. Disruption of the family unit, divorce, and other psychological
stresses which affect all members of the family are common. Specialized
pediatric rheumatology centers are able to provide a team of individuals
accustomed to dealing with children with chronic disabilities and their
families. This
comprehensive team approach is often associated with a superior outcome at a
lower overall cost.
Recommendations:
Children with
each of the following diagnoses should have the diagnosis confirmed and their
treatment plan monitored by a physician experienced in pediatric rheumatology.
acute rheumatic fever
lyme disease with arthritis
systemic lupus erythematosus
mixed connective tissue disease
progressive systemic sclerosis
linear scleroderma
dermatomyositis
polymyositis
polyarteritis nodosa
Wegener's granulomatosis
psoriatic arthritis
ankylosing spondylitis
systemic
onset juvenile rheumatoid arthritis
Behcets disease
unexplained
joint pains
In addition all children with musculoskeletal
complaints whose disease does not remit with therapy (including all of the diagnoses
listed above), as well as the following:
pauciarticular
onset juvenile rheumatoid arthritis
polyarticular juvenile rheumatoid arthritis
recurrent 'tendonitis'
unexplained 'low back pain'
recurrent 'toxic synovitis'
In the presence of a
known rheumatic disease or unknown musculoskeletal complaints any of the
following are indications for referral to a specialized pediatric rheumatology
center.
· any child who because of his
arthritis is developing persistent flexion contractures
·
any child who is requiring home tutoring
·
any child who is requiring the use of a wheel
chair or stroller (as age appropriate).
· any child requiring hospitalization
·
any child requiring corticosteroid therapy
The following diagnoses
require ongoing management by a physician experienced in pediatric rheumatology
Systemic lupus erythematosus
Dermatomyositis
Polyarteritis nodosa
Mixed connective tissue disease
Wegener's granulomatosis
Behcet's disease
sarcoidosis
systemic onset juvenile rheumatoid arthritis
For more information
designed for pediatricians, family practitioners, nurses and families, you may
wish to consult my book.
Click
here to order at a discount from Amazon.com!!
at
Amazon.com
“Dr. Tom Lehman’s experience and compassion are evident on every page of this
book, and they help guide the reader—child, parent, and
healthcare professional alike – through the
world of childhood arthritis. This book
is an absolute gem written with a single goal in mind: improve the lives of kids with arthritis.” -- Jack Klippel, M.D. President and
CEO of the Arthritis Foundation
“Dr. Lehman has given parents and families of children with
arthritis the first book that speaks to the parent and child as equals. His book explains the illnesses, the
medications, the lab tests, and the disease course in simple, understandable
lay language and givens them valuable insight into how a pediatric
rheumatologist thinks. Bravo!”-- Charles Spencer, M.D.,
Professor of Clinical Pediatrics,
It’s not just
growing pains.
A guide to childhood muscle, bone, and joint pain,
rheumatic diseases and the latest treatments
Click here to see the table of
contents
It
has always been a frustration trying to answer the many questions I have
received from people over the web. I can’t
take the time and give them the detail I would like to. I have to take care of my patients. This book is a distillation of my experience
answering questions for parents and health professionals over 25 years of
practice. If you want to know about the
diseases, the tests, the medications, or how to be sure you are getting the
best care– If you are the family member of a child with joint pains, this book will give you the answers. If you are a general physician, a
pediatrician, or a nurse who cares for children with these diseases it will
answer many of the questions families ask you, and you can recommend it to
them. It will also answer many of your
questions about what shots to give, what precautions to take, and the other
questions families, pediatricians, and other health care providers have asked
me over the years.
Dr. Lehman is
the author of many textbook chapters and articles on the care of children and
young adults with rheumatic diseases including SLE, JRA, dermatomyositis,
scleroderma,
Click here for BOOKS dealing with childhood rheumatic diseases
This site provided by Thomas J. A. Lehman MD
Chief, Division of Pediatric Rheumatology
The Hospital for Special
Surgery
535 E 70 St,
212-606-1151, fax 212-606-1938, e-mail goldscout@aol.com
Click here if you are
interested in making an appointment to see Dr. Lehman or in
referring a child.
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