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Pediatric rheumatology

If your child is experiencing pain in their muscles or joints, unexplained fevers or symptoms of an autoimmune or a rheumatic condition, such as juvenile idiopathic arthritis or lupus, our pediatric rheumatology team is here to guide you both through diagnosis and treatment.

What is a pediatric rheumatologist?

A pediatric rheumatologist is a doctor who has extensive training in diagnosing and treating children who have rheumatic conditions, like juvenile arthritis and other inflammatory disorders. These diseases can affect the joints, muscles, bones and connective tissues causing pain, swelling and stiffness.

When to see a rheumatologist

If your child complains of pain in their joints, muscles, bones or tendons, has symptoms of an autoimmune disorder or unexplained fevers, consider discussing the concern with your pediatrician.

They may refer you to a pediatric rheumatologist if your child:

Experiences symptoms of juvenile arthritis
Has unexplained, prolonged fevers
Experiences a dermatologic condition, such as rashes, photo sensitivity, severe acne or skin pigment changes
Has muscle weakness
Has unexplained weight loss
Has recurring redness in their eyes
Has recurring mouth sores
Has inflammation around the heart or lungs (called pericarditis and pleuritis)
Is anemic
Has low platelets (thrombocytopenia)
Has low white blood cells (leukopenia)

Your child’s pediatric rheumatology team

Your pediatric rheumatologist will work alongside your child’s pediatrician and other specialists, such as pediatric orthopaedists, neurologists or physical and occupational therapists, to make sure they get the comprehensive care they need. Your child’s care team may consist of:

A pediatric rheumatologist
A pediatric nephrologist (specializes in treating kidney disorders)
A pediatric cardiologist (specializes in treating heart conditions)
Physical and occupational therapists. Learn more about pediatric rehabilitation
A pediatric gastroenterologist (specializes in treating the gastrointestinal tract and liver)
A pediatric neurologist (specializes in treating conditions of the nervous system)
A pediatric radiologist
A pediatric orthopaedist (specializes in treating bone, joint and muscle conditions)
A psychologist or behavioral health specialist
Nutritionists
Nurses and medical assistants

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Pediatric rheumatology conditions we treat

From diagnosis to treatment and management of your child’s condition, our pediatric rheumatology team is dedicated to getting them back to their normal activities. Common conditions we treat include:

Arthritis associated with inflammatory bowel disease (IBD)
Juvenile dermatomyositis
Juvenile idiopathic arthritis (JIA)
Juvenile lupus
Juvenile scleroderma
Kawasaki disease
Lyme disease
Mixed connective tissue disease
Pediatric vasculitis diseases
Sarcoidosis
Uveitis, or inflammation of the eye

Diagnosing pediatric rheumatology conditions

When you and your child meet with your pediatric rheumatologist, they’ll start by discussing your child’s health history with you and will perform a physical exam. Your child may need additional tests to help diagnose their condition. These may include:

Blood tests

A blood test may be performed to help diagnose your child’s condition. These can include:

Antinuclear antibody (ANA) test - This test checks the levels of antibodies in your child’s blood.
Complete blood count (CBC) - This test helps your child’s specialist check their white blood cell, red blood cell and platelet levels.
Creatinine - This test can help diagnose kidney disease.
Hematocrit - This test helps measure the number of red blood cells in the blood.
Rheumatoid factor test - This test can help diagnose rheumatoid arthritis.
Sedimentation rate - This test can help detect inflammation in your child’s body.
White blood cell count - This test helps measure the number of white blood cells in the blood.

Other tests

Depending on your child’s specific condition and needs, their specialist may perform other tests to help diagnose their condition. These may include:

HLA tissue typing - This can help your child’s specialist identify genetic markers of ankylosing spondylitis.
Joint aspiration (arthrocentesis) - A small sample of fluid is taken from your child’s joint and is then tested to see if crystals, bacteria or viruses are present.
Muscle biopsy - Your child’s specialist will take small pieces of tissue to check under a microscope. This can help diagnose conditions that affect muscles, including vasculitis.
Skin biopsy - Your child’s specialist will take small pieces of tissue to check under a microscope. This can help diagnose a type of arthritis that involves the skin, such as lupus or psoriatic arthritis.
Urine test - This can help your child’s specialist check for protein and various kinds of blood cells.
X-rays or other imaging tests - These can help your child’s specialist take a closer look at the potential damage to their joint.

Treatment for pediatric rheumatology conditions

Treatment for your child’s rheumatic condition will depend largely on their symptoms, age and the type and severity of their condition. Once your specialist diagnoses your child’s condition, they’ll work with a team (including your child’s pediatrician) to create a treatment plan that’s tailored to their specific needs.

Since many pediatric rheumatic conditions are chronic, or long-term, our team’s focus is helping you and your child manage their condition by reducing pain and inflammation, protecting their joints and getting them back to the activities they enjoy.

Depending on your child’s unique situation, one or more of the following treatments may be recommended:

Lifestyle changes and physical therapy

Depending on your child’s situation and condition, their specialist may suggest weight loss to help reduce stress placed on their joints. They may also suggest certain low-impact exercises and stretches to help ease joint pain and stiffness.

To help ease pain and swelling without medication, your child’s specialist may suggest using hot and cold therapy using heating pads and ice packs. They may also suggest the use of a brace or other assistive devices, like a cane or crutches, to help reduce stress placed on their joint. Massage therapy may also be suggested to help ease muscle tension.

Medications

These may include short-term pain relievers to help reduce pain and inflammation, or long-term medications to help manage inflammation, swelling and to treat any immune system issues your child may experience due to their condition.

Surgery

In more severe cases, your child’s specialist may suggest a surgery to either repair or replace a joint that’s been damaged due to their condition.

Pediatric rheumatology care at Geisinger

No matter the rheumatic condition your child is experiencing, our team is dedicated to helping them manage it — so they can get back to being a kid. We offer:

Personalized, compassionate care for children: Your child is more than a patient to us ― they deserve the very best care available. Our pediatric rheumatology team will work with you and your child to create a treatment plan that fits their unique needs.
World-class care in your neighborhood: With Geisinger Janet Weis Children’s Hospital located in Danville and many pediatric offices (and specialists) throughout Pennsylvania, exceptional care for your child is never far from home.
Treatments powered by research: From minor to more serious conditions, our drive to improve the health and lives of children is constant. Through ongoing education, research and innovation, we’re here to evolve pediatric rheumatology care — using the latest research-based treatments to care for your child.
Family support: We see your family like our family. As community-based advocates for children and their loved ones, we’re here to guide families at every step — from programs to community support and resources.