By Thomas J.A. Lehman
Within the usa by myself, approximately 300,000 kids be afflicted by a few type of arthritis or rheumatic sickness, and thousands extra are vulnerable to constructing this sort of ailments. during this marvelously down-to-earth consultant, Thomas Lehman--the head of 1 of the prime pediatric rheumatology courses within the world--offers a gold mine of professional suggestion beneficial for pediatricians who are looking to develop into more adept in figuring out, diagnosing, and treating rheumatic affliction in young children. Dr. Lehman is helping pediatricians interpret their sufferers' lawsuits and verify even if and what form of clinical consciousness is required, explaining what signs to appear for, what inquiries to ask, what checks to run, and what to anticipate while therapy starts. utilizing illustrative anecdotes, this publication sheds gentle on quite a lot of rheumatic disorders--including juvenile arthritis, Lyme illness, lupus, Kawasaki ailment, fibromyalgia, and persistent fatigue syndrome--and it addresses such the most important issues as drug defense, genetic concerns, the capability dangers to little ones posed via medicines, the trouble of kin lifestyles while a toddler has a prolonged sickness, and lots more and plenty extra. A Clinician's advisor to Rheumatic illnesses in teenagers captures the services of a committed healthcare professional with over thirty years of hands-on event assisting little ones lead general, satisfied lives. it is going to aid pediatricians ensure that sufferers in attaining the absolute best consequence.
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Additional info for A Clinician's Guide to Rheumatic Diseases in Children
Since the neck is simply the top portion of the back, the same questions need to be asked about complaints here. Several additional questions should also be asked: • Is the child having headaches? Do they occur at the same time as the neck pain? • Is the child having jaw pain? ) • Is the child having problems seeing? • What type of pillow does the child use? Muscular Irritation Wryneck (torticollis) is a condition in which the child holds the head to one side because of problems with the sternocleidomastoid muscle.
N E C K PA I N Neck pain in children is rare. Most often it is due to irritation involving the muscles that hold the head and shoulders in the proper position. Muscle irritation that the child describes as neck pain may be the result of an improperly carried backpack, especially if a heavy backpack is slung over just one shoulder. Common Causes of Pain 47 Carrying an excessive weight on one side places unnecessary strain on the back, the shoulder itself, and the neck muscles. , whiplash) Severe sore throat Jaw pain Uncorrected visual problems causing the child to hold the head tilted Bone problems Congenital abnormalities Osteoid osteoma Herniated disc (rare without known injury) Infection Spondyloarthropathies (enthesitis-associated arthritis) Juvenile arthritis When evaluating a child’s complaints of neck pain, think about the answers to the questions at the beginning of the section on back pain.
Usually scoliosis and spondylolisthesis begin without symptoms, but over time compensatory changes occur that often cause mechanical pain. Speciﬁc conditions Scoliosis Overview Scoliosis is an abnormal curvature of the spine with rotation of the vertebrae. This curvature often results in one shoulder appearing higher than the other or the hips appearing uneven. Diagnosis Since the curvature occurs with growth, it is rare for scoliosis to become evident before the age of ten years. Children are routinely screened for scoliosis at school, 42 A C H I L D C O M P L A I N S O F PA I N but the expertise and thoroughness of the examiners vary widely.