Services and Programs

Pediatric Rheumatology/Immunology

Arthritis Program

Juvenile arthritis is one of the conditions diagnosed and cared for in the Pediatric Rheumatology/ Immunology Division. According to the Arthritis Foundation, nearly 300,000 children in the United States have one of the many different forms of juvenile arthritis / rheumatic disease.

The Golisano Children’s Hospital at Strong offers the only multidisciplinary team of pediatric rheumatologists and allied health professionals in the Finger Lakes Region. Care is individualized and conforms to accepted guidelines and policies developed by the Pediatric Rheumatology professional community.

Did You Know… Pediatric rheumatologists are in low supply across the nation. Fewer than 175 board certified pediatric rheumatologists practice in the United States (Source: Geographic Distribution of Diplomats by Subspecialty Certificate, American Board of Medical Specialties).

Our Program provides diagnosis, education, and initial and ongoing management of children with arthritis from infancy through late adolescence. Our goals are to:

• Establish an accurate and appropriate diagnosis;
• Relieve pain and discomfort;
• Prevent disease progression, including joint deformity;
• Reduce or eliminate factors that may inhibit normal growth;
• Maximize physical and social functioning;
• Facilitate disease transition to remission.

• Pediatric rheumatologists
• Physical therapists
• Occupational therapists

We also collaborate with a broad range of other health care professionals to help your child lead a full and active life, including:

• Neurologists
• Nurses
• Nutritionists
• Ophthalmologists
• Orthopaedists
• Psychologists
• Social Workers

• Our pediatric rheumatologists make a diagnosis based on medical history, physical examination, and laboratory and imaging studies. Subtle signs of joint inflammation and destruction may exist if the disease has progressed, making bone and joint imaging useful. More sophisticated diagnostic tests are used to rule out other illness and to identify a specific type of arthritis. The medical center maintains its own immunology lab to perform the most complex tests.

• Care plans are individualized depending on the child’s age and the type and activity of the disease. We work to balance short-term and long-term goals (such as inflammation control versus the potential of some treatments to inhibit growth).

• Patient and caregiver education about the nature and course of the disease is emphasized to help both you and your child or adolescent to:
  • Take better care of disease symptoms;
  • Arrange for special accommodations when needed;
  • Actively participate in decision-making and treatment choices.

Juvenile Arthritis Facts Arthritis often presents differently in children than in adults and can result in symptoms not seen in adults. These conditions can: •Strike children of all ages and backgrounds; •Last from several months to many years; •Cause pain, stiffness, and swelling in joints as well as in muscles, tendons, ligaments, bones and skin, and eye inflammation (uveitis or iritis); •Sometimes come back in adulthood or persist into adulthood; •If not treated, lead to deformities or scarring in joints within the first two years of the disease; • Compromise the heart, lungs and kidneys in certain severe cases; •Interfere with psychological, social and intellectual development.

About Treatment Options Many different techniques are usually necessary to successfully treat juvenile arthritis. They include: Drug therapy. Most children with arthritis respond to medications. These include: Nonsteroidal anti-inflammatory medications (NSAIDS) Disease-modifying agents (DMAR) Newer biologic agents (e.g., etanercept, infliximab, etc.) Other immunosuppressive therapy may be used for severe and/or systemic disease. Splinting. Exercise. These are designed specifically for your child. They change depending on whether your child needs to restore lost motion in a joint, maintain motion and flexibility or strengthen muscles. Assistive devices. Nutrition. Some medications require changes in your child's dietary needs. Also, some types of arthritis may cause growth abnormalities. Surgery. Most children with arthritis don’t require surgery. However, in rare circumstances it may be necessary to relieve pain, release a joint from tight tissues to allow it to return to a normal position or replace a severely damaged joint. Total joint replacement is usually reserved for children whose growth is complete.