Juvenile Idiopathic Arthritis
Arthritis is one of the most common chronic diseases of children and youth, and an important cause of short- and long-term disability. There are many causes of chronic arthritis, but…
Pharmacology and Drug Therapy: Nonbiologic Therapies
The principal drugs used in pediatric rheumatology are drugs that suppress the inflammatory and immune responses. This chapter outlines important general principles relating to these medications, particularly as they apply…
Occupational and Physical Therapy for Children with Rheumatic Diseases
The goal of occupational and physical therapy in the treatment of children with rheumatic diseases is to enable them to participate in all the activities of everyday life. Integrating cultural…
Pain and Its Assessment
Chronic or intermittent pain is a primary symptom of many pediatric rheumatic diseases, especially arthritis. Patients often report mild to moderate pain. About 25% to 30% report moderate to severe…
Pharmacology: Biologics
Biologics are different from nonbiologic disease-modifying antirheumatic drugs (DMARDs) in that they are produced by biologic processes rather than chemical syntheses and target specific, well-defined molecules expressed on cells or…
Managing Children with Rheumatic Diseases
Rheumatic diseases are chronic, multisystem disorders characterized by an unpredictable course with periods of exacerbation and remission. Optimal care requires the expertise of many disciplines ( Table 11-1 , Fig….
Assessment of Health Status, Function, and Quality of Life Outcomes
Pediatric rheumatic diseases influence many, if not all, aspects of a child’s life—not only physical, but also social, emotional, educational, and economic. The impact of pediatric rheumatic disease is not…
Trial Design, Measurement, and Analysis of Clinical Investigations
Evidence-Based Medicine and Clinical Investigation Today more than ever, clinicians are encouraged to practice evidence-based medicine (i.e., the conscientious, explicit, and judicious use of current best evidence in making decisions…
Inflammation and Its Mediators
The immune system, the function of which is to protect against infections, comprises two branches: a more primitive one called innate (natural, native) immunity and the more recently evolved one…
Structure and Function
Inflammation, the fundamental pathologic process in rheumatic diseases, may disrupt the anatomy and function of any structure or tissue. Those structures primarily affected in rheumatic diseases are the connective tissues,…
