Outcome Measures in Pediatric Rheumatology.

Children with rheumatologic disorders need periodic systematic evaluation of their disease status so that all aspects of the child’s life that are affected can be adequately assessed. The commonest rheumatologic disease that afflicts children is Juvenile Idiopathic Arthritis (JIA). The child with JIA should have several domains assessed at regular intervals. These outcome measures include the physical, functional and the quality of life assessment measures. No single measure can capture the full impact of the disease on the child’s life. This article highlights the key outcome measures in a child with JIA and introduces the readers to several disease measurement tools that have been developed for assessment of outcome for the child with JIA.

Laboratory tests in pediatric rheumatology.

Abstract Laboratory tests in rheumatology are important tools that help to support the diagnosis of autoimmune diseases, evaluate the disease activity, monitor the side effects of therapy, and also assist the physician to exclude rheumatologic mimics. Few relevant tests should be ordered after a detailed clinical review of the patient has been carried out and a provisional clinical diagnosis has been reached. There is no test that can rule in or rule out any rheumatologic disease and therefore, there is no role of a detailed “Rheumatology panel” of investigations. In this review, routine blood investigations, acute phase reactants, auto antibodies, HLA B27 and complements have been discussed.

The place of pediatric rheumatology in India.

Abstract Rheumatology is a relatively new specialty in the field of Pediatrics in India where there are only a few centres of excellence. Awareness about these conditions in childhood is lacking and patients are often referred late resulting in poor long term outcomes. This article highlights the needs of the paediatric rheumatology patients which are complex and should encompass both acute and chronic care and also plan a smooth transition to the adult rheumatology world. In the year 2010, attaining remission is the goal for every child with a rheumatologic disorder, which is seldom achieved for the Indian pediatric rheumatologic patient. The article discusses the reasons for poor awareness, the current outcome for these patients and details the burden of disease in India. The health care delivery system and finally the way forward have been discussed.

Management of juvenile idiopathic arthritis.

Juvenile idiopathic arthritis (JIA) is a relatively uncommon disorder in childhood. Expertise however should be the corner stone of care of children with JIA, as early appropriate treatment is mandatory to ensure best possible short and long-term outcome for children with JIA. Therefore comprehensive treatment centers (with multi disciplinary teams) should be based in tertiary level academic centers. This article deals with both specific and generic issues encountered in managing children with JIA.