Pediatrics

Pediatric Rheumatology

Doctor with pediatric patient

Rheumatology is a specialty that treats pain in the musculoskeletal system (joints, muscles, bones, or tendons), arthritis, and autoimmune disorders, many of which cause inflammation. In addition to juvenile arthritis, some common diseases include juvenile systemic lupus, vasculitis, and fibromyalgia. Treating these diseases in children has special challenges, partly because they are not always able to communicate what they are feeling. Their bodies are also growing quickly, and they have different medical needs than adults. These diseases can also affect a child’s physical, intellectual, emotional, and social development.

The goal of the pediatric rheumatology team at Mount Sinai is to help children and adolescents with these diseases lead full and active lives. Our results rely on a combination of the most advanced science and treatments, as well as compassionate care and communication. We partner closely with patients and families to personalize treatment to ensure the best possible outcomes, as well as meet individual needs.

Conditions and Treatments

“Rheumatism” was used in the past to describe a wide range of inflammatory disorders of the joints and connective tissue. Today, we know that many of them are linked to diseases of the immune system as well. Doctors no longer use the broad term “rheumatism,” stressing the importance of a more specific diagnosis. Each of these conditions has their own set of causes and symptoms, requiring a specific plan of treatment. Our team has expertise in treating children and adolescents for disorders such as:

  • Juvenile arthritis is an umbrella term used to describe the many autoimmune and inflammatory conditions or rheumatic diseases that can develop in children. Although the various types of juvenile arthritis share many common symptoms, like pain, joint swelling, redness, and warmth, each type is distinct and has its own special concerns and symptoms. Some types of juvenile arthritis affect the musculoskeletal system, but joint symptoms may be minor or nonexistent. Juvenile arthritis can also involve the eyes, skin, muscles, and gastrointestinal tract.
  • Systemic lupus erythematosus is an autoimmune disease in which the immune system of the body mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs.
  • Acute rheumatic fever can develop if strep throat and scarlet fever are not treated properly. If untreated, it can affect the heart, joints, brain, and skin. However, it is rare in the United States and most efforts have been focused on prevention.
  • Fibromyalgia is a condition with symptoms of widespread musculoskeletal pain accompanied by fatigue and issues with sleep, memory, and mood. Research indicates that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.
  • Amplified musculoskeletal pain syndrome is, in effect, a “short circuit” in the nervous system. The normal pain signal goes not only to the brain, but also to the nerves that control blood vessels in muscles, which constrict in response to the pain. This causes a restriction of oxygen and buildup of waste products which, in turn, cause more pain.
  • Juvenile dermatomyositis is a disease in children which causes skin rash and muscle inflammation. It’s an autoimmune disease in which the immune system attacks the body’s own tissues and cells, resulting in weak muscles, inflammation, and in some cases, tissue damage.
  • Vasculitis is an umbrella term for a number of diseases that cause inflammation of the blood vessels. In children, Kawasaki disease and Henoch-Schönlein purpura are types of vasculitis.
  • Raynaud’s phenomenon is a rare disorder of the blood vessels, usually in the fingers and toes. It causes the blood vessels to narrow when a child is cold or feeling stressed. When this happens, blood can't get to the surface of the skin and the affected areas turn white and blue.
  • Lyme disease is an infectious disease caused by a bacterium carried by ticks. Early symptoms may include skin rash, fever, headache, and tiredness. If untreated, symptoms may include the loss of the ability to move one or both sides of the face, joint pain, severe headaches with neck stiffness, and heart palpitations.
  • Autoimmune encephalitis is an inflammation of the brain caused by the immune system attacking healthy brain cells. Symptoms may include neurologic or psychiatric disorders ranging from impaired memory to psychosis and aggression.
  • Chronic recurrent multifocal osteomyelitis is a rare bone disease that causes inflammation primarily in children and adolescents. Symptoms include periodic fevers, deep aching bone pain that can cause limping, and bone lesions that can develop anywhere in the body.
  • Juvenile scleroderma literally means “hard skin” and is an autoimmune disease which causes inflammation of the skin and fibrosis, or hardening and scarring of the tissue.

Therapies and Treatments

Some of the most common treatments for rheumatic diseases include:

  • Steroids are used as the front-line treatment for many inflammatory conditions, such as rheumatoid arthritis, lupus, vasculitis, and myositis.
  • Autoimmune suppressors work by turning off parts of the immune system, so that the body doesn’t attack healthy cells. Some of these medications are more targeted than others, affecting specific molecules which signal the body’s ability to regulate inflammation.
  • Physical therapy is an important component of a holistic therapeutic approach. It maintains or increases mobility, and is also helpful in promoting a positive mental attitude.

Mount Sinai Kravis Children’s Hospital offers a variety of counseling and support programs for patients, parents and caregivers. It’s important that the family play a part in the child or adolescent’s therapy. We promote a collaborative team approach to help each patient achieve their best outcome.

Why Choose Us

We bring experience, compassion, and the most advanced science to each patient we see. The pediatric rheumatology team includes nationally recognized clinical experts, engaged in groundbreaking research. But equally important to patients and families is the exceptional care and compassion we provide. We partner with patients and families every step of the way to ensure the best possible patient outcomes. With state-of-the-art diagnostics, technology, and treatments, you can be sure that your child will receive the best care possible. We are constantly uncovering new knowledge and applying it to the way we deliver care. And with all the resources of the Mount Sinai Health System at your disposal, you will have a powerful team on your side.