PGALS: Approach to Child with Arthritis. Prof Chris Scott Paediatric Rheumatology
|
|
|
- Frank Lenard Webb
- 6 years ago
- Views:
Transcription
1 PGALS: Approach to Child with Arthritis Prof Chris Scott Paediatric Rheumatology
2 Introduction In a prospective study from The Royal Hospital for Sick Children, Edinburgh, every 58th child presented with an acute atraumatic limp. A survey of adolescents in British Columbia revealed that musculoskeletal complaints were perceived as the 2 nd most common health concern after acne. Juvenile Arthritis is the most common cause of musculoskeletal disability in children. Musculoskeletal pain can be the presenting feature of many different conditions, including life threatening conditions Fischer SU Foster & Cabral, 2006
3 Poor training of Paediatricians and GP s in PR Lack of resources Poor training Perception of rarity Underdiagnosis Poor exposure
4 Case Presentation 14 month girl Presents with toe walking 5 week history
5
6 Age appropriate differential diagnoses Any age Age 0-4 yrs Age 4-10 yrs Age yrs Trauma Septic arthritis Reactive arthritis Juvenile idiopathic arthritis (JIA) Malignancy Developmental dysplasia of the hip Transient synovitis Non-accidental injury Perthe s Transient synovitis Slipped upper femoral epiphysis (SUFE)
7 History Onset Pain: Sudden (injury, Septic) vs indolent (JIA) Timing Pain: EMS Nocturnal Pain Bone Pain Intensity Pain: JIA not severe Enthesitis can be Severe septic, malignancy or amplified pain Disability: Severe not common in early JIA Response to Meds: JIA, reactiveand Osteoid Osteoma Malignancy and septic not Family: Psoriaisis, Ank spond, crohns, Lupus? Social, infectious contacts, immunisations, Growth etc
8
9 SEPSIS Complete non-weight bearing Any attempt to move the limb causes extreme distress Constant severe pain Night pain and waking Fever Immunocompromised child - due to primary disease or medications JUVENILE IDIOPATHIC ARTHRITIS Joint swelling lasting > 6 weeks Stiffness / slowness in the mornings Joint pain may not be verbalised in the very young child and may manifest as being grumpy, clumsy or avoiding activities Regression of achieved milestones RED FLAGS Leg length discrepancy and muscle wasting suggest chronicity (many months) MALIGNANCY Night pain Severe and non-remitting pain Pallor, bruising, anaemia, thrombocytopenia Lymphadenopathy Hepatosplenomegaly Systemic symptoms - lethargy, weight loss, night sweats, fever Back pain in the unwell child NON ACCIDENTAL INJURY Delay in seeking medical attention Changeable history inconsistent with pattern of injury or developmental stage of the child Repeated presentations Un-witnessed injury Complete non-weight bearing with occult fracture
10 Case Presentation 14 month girl Presents with toe walking Left side only 5 week history Timing: initially only in morning Cries often when taken out of bed and refuses to walk? pain Now most of the time No weight loss, no fever, no systemic features Previously well Development normal Milestones appropriate, walked normally from months.
11 O/E First full general and systems based on excluding differential Then MSK screen (PGALS) If any abnormality: Full joint exam Look for features specific suspected autoimmune diseases
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28 Specific Features: Skin Psoriasis White scaly plaques Vasculitis: Henoch Schonlein Purpura Kawasaki Disease Bechets Polyarteritis Nodosa SLE sjia Juvenile Dermatomyositis Sarcoidosis/Blau s disease Inflammatory Bowel Disease Scleroderma Palpable purpura on the lower limbs Polymorphous erythematous macules over trunk. Can be variable. Later peeling of the fingers and toes is characteristic. Oral or genital ulcers, papulopustular lesions, erythema nodosum Variable, erythema multiforme, skin nodules, livedo reticularis Malar rash, discoid lupus, vasculitis rash, photosensitivity Salmon patches Heliotrope rash around the eyes, gottrons papules over extensor surfaces, skin ulceration, calcinosis, periungual erythema erythematous/tan coluored maculopapular rash, Panniculitis Erythema nodosum, pyoderma gangernosum Oedema, sclerosis,
29 Eyes
30
31
32
A free online interactive information resource for clinicians.
A free online interactive information resource for clinicians www.pmmonline.org The limping child Helen Foster Professor of Paediatric Rheumatology Newcastle University Honorary Consultant Great North
Department of Paediatrics Clinical Guideline. Guideline for the child with possible arthritis (joint swelling/pain, loss of function)
Department of Paediatrics Clinical Guideline Guideline for the child with possible arthritis (joint swelling/pain, loss of function) Definition: Juvenile Idiopathic Arthritis (JIA) is defined as arthritis
2/23/18. Disclosures. Rheumatic Diseases of Childhood. Making Room for Rheumatology. I have nothing to disclose. James J.
Making Room for Rheumatology James J. Nocton, MD Disclosures I have nothing to disclose Rheumatic Diseases of Childhood Juvenile Idiopathic Arthritis (JIA) Systemic Lupus Erythematosus (SLE) Juvenile Dermatomyositis
Rheumatology 101 A Pediatrician s Guide
Rheumatology 101 A Pediatrician s Guide Pediatric Staff and Alumni Day 2016 Dawn M. Wahezi, Yonit Sterba, Tamar Rubinstein Disclosures None Pick a Group Group 1 A child with a limp Group 2 ANA To test
Department of Paediatrics Clinical Guideline
Department of Paediatrics Clinical Guideline The child and young person with possible arthritis (joint swelling and/or pain, loss of function for >4 weeks) Definition: Juvenile Idiopathic Arthritis (JIA)
THE MANAGEMENT OF JUVENILE IDIOPATHIC ARTHRITIS
THE MANAGEMENT OF JUVENILE IDIOPATHIC ARTHRITIS Prof Chris Scott PAEDIATRIC RHEUMATOLOGIST UNIVERSITY OF CAPE TOWN RED CROSS WAR MEMORIAL CHILDRENS S HOSPITAL Chronic Arthritis >6wks JIA No other cause
The Child With a Limp
KID WITH A LIMP Common in ED, common in Exams Differential diagnosis is very wide Most causes benign, but mustn't miss Septic arthritis Osteomyelitis Fractures / NAI SUFE (older, heavier children) The
Non-inflammatory joint pain
Non-inflammatory joint pain Lawrence Owino Okong o, Mmed (UoN); Mphil. (UCT). Lecturer, Department of Paediatrics and Child Health, University of Nairobi. Paediatrician/ Rheumatologist. INTRODUCTION Musculoskeletal
Assessment of limping child (beware the child who does not weight bear at all):
Department of Paediatrics Clinical Guideline Acutely Limping Child and Septic Arthritis Assessment of limping child (beware the child who does not weight bear at all): History Careful history of any significant
Juvenile Chronic Arthritis
Juvenile Chronic Arthritis Dr. Christa Visser MBChB MMed (Med Phys) Diploma Musculoskeletal Medicine (UK), Member Society of Orthopaedic Medicine (UK) Childhood Arthritis JCA/JIA/JRA Remember Acute rheumatic
Childhood Cancer. Dr Sarah Taaffe. Grace Kelly LadyBird Trust RCGP Child and Young Persons Cancer E-learning Session
Childhood Cancer Dr Sarah Taaffe Grace Kelly LadyBird Trust RCGP Child and Young Persons Cancer E-learning Session What I plan to cover in this session Background- Why this topic.. What types of cancer
Differential diagnostics in Rheumatology
Differential diagnostics in Rheumatology number of affected joints lengths of duration Acute monoarthritis Chronic monoarthritis Acute polyarthritis Chronic polyarthritis Acute monoarthritis Infective
The Child with a Limp
The Child with a Limp DR S Rajapaksa RCH CHIld with a limp Case: An 11 year old presents to ED with a 4 days history of a painful limp. He had been playing footie over the weekend and had fallen but then
Musculoskeletal Referral Guidelines
Musculoskeletal Referral Guidelines Introduction These guidelines have been developed to provide an integrated musculoskeletal service. They are based on reasonable clinical practice and will initially
Systemic forms of stiffness
Systemic forms of stiffness ANNA LITWIC CONSULTANT RHEUMATOLOGIST SALISBURY DISTRICT HOSPITAL CLINICAL RESEARCH FELLOW MRC LIFECOURSE EPIDEMIOLOGY UNIT Overview Rheumatoid arthritis Know it when you see
JuvenileIdiopathicArthritis. Dr Johan Siebert
JuvenileIdiopathicArthritis Dr Johan Siebert 1 NORMAL DIARTHRODIAL JOINT Synovial is a thin membrane enclosing the joint space The joint space contains fluid that bathes the joint and reduces friction
MANAGING THE PATIENT WITH POSITIVE ANA
MANAGING THE PATIENT WITH POSITIVE ANA Rafael F. Rivas-Chacon, M.D. Disclosures Grant/Research support for: Pfizer Study JIA A3921104 Tofacitinib not related to this presentation 1 Positive Antinuclear
Common Cutaneous Signs of Medical Illnesses
Common Cutaneous Signs of Medical Illnesses DR COLIN THENG MBBS, MMED (FAM. MED), MRCP(UK), FAMS SENIOR CONSULTANT DERMATOLOGIST THE SKIN SPECIALISTS & LASER CLINIC MOUNT ALVERNIA MEDICAL CENTRE D, #07-61
Juvenile Idiopathic Arthritis (JIA)
Juvenile Idiopathic Arthritis (JIA) Kaveh Ardalan, MD, MS Division of Rheumatology Ann & Robert H. Lurie Children s Hospital of Chicago Assistant Professor, Pediatrics and Medical Social Sciences Northwestern
Reporting Autoimmune Diseases in Hematopoietic Stem Cell Transplantation
Reporting Autoimmune Diseases in Hematopoietic Stem Cell Transplantation Marcelo C. Pasquini, MD, MSc HVD05_1.ppt Outline Review of autoimmune diseases (AID). Role of transplantation for AID Data collection:
RARE JUVENILE PRIMARY SYSTEMIC VASCULITIS
www.pediatric-rheumathology.printo.it RARE JUVENILE PRIMARY SYSTEMIC VASCULITIS WHAT IS IT? Vasculitis is an inflammation of blood vessels. Vasculitides cover a wide group of diseases. Primary vasculitis
RHEUMATOLOGY OVERVIEW. Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center
RHEUMATOLOGY OVERVIEW Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center What is Rheumatology? Medical science devoted to the rheumatic diseases
GROWING PAINS A PRACTICAL GUIDE FOR PRIMARY CARE
REPORTS ON THE RHEUMATIC DISEASES SERIES 6 Hands On Practical advice on management of rheumatic disease GROWING PAINS A PRACTICAL GUIDE FOR PRIMARY CARE Helen E Foster Professor in Paediatric Rheumatology*
Joint Trust Guidelines for the Limping Child with No History of Trauma
A Clinical Guideline For Use in: Children s Assessment Unit By: Medical and Nursing staff Children (0-16) presenting with a limp or acute For: lower limb pain but with no history of trauma Division responsible
Juvenile Spondyloarthritis / Enthesitis Related Arthritis (SpA-ERA)
www.printo.it/pediatric-rheumatology/gb/intro Juvenile Spondyloarthritis / Enthesitis Related Arthritis (SpA-ERA) Version of 2016 1. WHAT IS JUVENILE SPONDYLOARTHRITIS/ENTHESITIS- RELATED ARTHRITIS (SpA-ERA)
Pediatric Rheumatology: A Case-based Approach to the Basics. Hilary M. Haftel, MD, MHPE University of Michigan Department of Pediatrics
Pediatric Rheumatology: A Case-based Approach to the Basics Hilary M. Haftel, MD, MHPE University of Michigan Department of Pediatrics Disclosures I have no relevant financial relationships with the manufacturer(s)
Growing Pains in Children 1.0 Contact Hour Presented by: CEU Professor
Growing Pains in Children 1.0 Contact Hour Presented by: CEU Professor 7 www.ceuprofessoronline.com Copyright 8 2008 The Magellan Group, LLC All Rights Reserved. Reproduction and distribution of these
Financial Report. Moving Together
Financial Report 2013 Moving Together Our Purpose To improve the quality of life of people who have, or are at risk of developing musculoskeletal conditions. Our Values Respect and integrity Service and
Approach to Musculoskeletal Assessment. a.k.a a Rheumatologist s search for the Holy Grail a story by Roger Allen
Approach to Musculoskeletal Assessment a.k.a a Rheumatologist s search for the Holy Grail a story by Roger Allen Genevieve 16 yr girl Elite gymnast (20+ hours/wk) FHx: Mother hypocomplementaemic vasculitis
Jeopardy. What s the rash? $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400
Jeopardy Antibodies & more antibodies Aching joints What s the rash? Potpourri Image Challenge $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400 $500 $500
Dermatology GP Referral Guidelines
Austin Health Dermatology Department holds 5 Clinic sessions to discuss and plan the treatment of with Dermatology conditions. Department of Health clinical urgency categories for specialist clinics Urgent:
IMACS FORM 07b: MYOSITIS DISEASE ACTIVITY ASSESSMENT TOOL, Version
IMACS FORM 07b: MYOSITIS ASSESSMENT TOOL, Version 2 2005 Subject s IMACS number: ASSESSOR: Date Assessed: Assessment number: The clinical features recorded are based upon the previous 4 weeks and the judgment
Patient with Musculo-skeletal Complaints - Summary
Patient with Musculo-skeletal Complaints - Summary 1. Soft Tissue Rheumatism or Arthritis 2. Arthritis Monoarticular Polyarticular - :- (Asymmetrical) (Symetrical) :- -Crystals, Gout - Infective acute
Skin Deep: Cutaneous Lupus. Dr Sarah Sasson Immunology Registrar, Liverpool Hospital 2016
Skin Deep: Cutaneous Lupus Dr Sarah Sasson Immunology Registrar, Liverpool Hospital 2016 Introduction: Cutaneous lupus erythematosus LE is an autoimmune disease with a range of clinical manifestations
Pyrexia of unknown origin? Think still
Pyrexia of unknown origin? Think still Lawrence Owino Okong o, Mmed (UoN); Mphil. (UCT). Lecturer, Department of Paediatrics and Child Health, University of Nairobi. Paediatrician/ Rheumatologist. DISCLAIMER
PAEDIATRIC VASCULITIS
PAEDIATRIC VASCULITIS Lawrence Owino Okong o, Mmed (UoN); Mphil. (UCT). Lecturer, Department of Paediatrics and Child Health, University of Nairobi. Paediatrician/ Rheumatologist. OUTLINE Introduction
Swollen Joints in Children
Swollen Joints in Children Version: 1 Approval Committee: Date of Approval: 25/06/2018 Ratification Group (e.g. Clinical network): Date of Ratification 18/04/2018 Signature of ratifying Group Chair Wessex
Physical examination of the musculosceletal- and nervous system. Pánczél Pál dr.
Physical examination of the musculosceletal- and nervous system in the practice of internal medicine. Pánczél Pál dr. Bursae = sacks of the synovial membrane fulfilled with synovium. Localised between
Cutaneous manifestations of Systemic Lupus Erythematosus
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 17, Issue 5 Ver. 11 (May. 2018), PP 01-08 www.iosrjournals.org Cutaneous manifestations of Systemic Lupus
Henoch-Schonlein Purpura Guidelines
Henoch-Schonlein Purpura Guidelines Henoch-Schonlein purpura (HSP) is the commonest vasculitis of childhood which is selflimiting in majority of cases. Epidemiology: Incidence varies from 10-20 per 100000
CONTENT OUTLINE. Pediatric Rheumatology
THE AMERICAN BOARD OF PEDIATRICS CONTENT OUTLINE Pediatric Rheumatology Subspecialty In-Training, Certification, and Maintenance of Certification (MOC) Examinations INTRODUCTION This document was prepared
Curricular Components for Rheumatology EPA
Curricular Components for Rheumatology EPA 1. EPA Title Manage patients with acute or chronic complex multi-system rheumatic disease in an ambulatory, emergency, or inpatient setting. 2. Description of
The Limping Child: Differential Diagnosis
The Limping Child: Differential Diagnosis Kathryn A Keeler, MD Assistant Professor University of Missouri-Kansas City School of Medicine, Department of Orthopaedic Surgery and Department of Pediatrics
Rheumatology Educational Goals & Objectives
Rheumatology Educational Goals & Objectives Musculoskeletal complaints are very common in the practice of primary care. They may reflect overuse or trauma, or be a manifestation of a broad range of musculoskeletal
A Patient s Guide to Transient Synovitis of the Hip in Children
A Patient s Guide to Transient Synovitis of the Hip in Children 651 Old Country Road Plainview, NY 11803 Phone: 5166818822 Fax: 5166813332 p.lettieri@aol.com DISCLAIMER: The information in this booklet
Familial Mediterranean Fever
www.printo.it/pediatric-rheumatology/gb/intro Familial Mediterranean Fever Version of 2016 1. WHAT IS FMF 1.1 What is it? Familial Mediterranean Fever (FMF) is a genetically transmitted disease. Patients
Objectives. Joint Pain. Case 1. Rheumatology for the Primary MD (Not just your grandmother s disease) 12/4/2010
Objectives Rheumatology for the Primary MD (Not just your grandmother s disease) Identify when it is appropriate to refer for rheumatologic evaluation Autoimmune/ Inflammatory v. noninflammatory disease
THE HIP. Cooler than cool, the pinnacle of what is "it". Beyond all trends and conventional coolness.
THE HIP Cooler than cool, the pinnacle of what is "it". Beyond all trends and conventional coolness. Objectives Hip anatomy Causes of hip pain Hip exam Anatomy Bones Ilium Anterior Superior Iliac Spine
AUTOIMMUNE DISORDERS IN THE ACUTE SETTING
AUTOIMMUNE DISORDERS IN THE ACUTE SETTING Diagnosis and Treatment Goals Aimee Borazanci, MD BNI Neuroimmunology Objectives Give an update on the causes for admission, clinical features, and outcomes of
Skin manifestations of systemic disease
THEME weird skin stuff Adriene Lee BSc(Med), MBBS(Hons), FACD, is visiting dermatologist, St Vincent's Hospital and Monash Medical Centre, and Lecturer, Department of General Practice, Monash University,
REFERRAL GUIDELINES: RHEUMATOLOGY
Outpatient Page 1 1 REFERRAL GUIDELINES: RHEUMATOLOGY Date of birth Demographic Contact details (including mobile phone) Clinical Reason for referral Duration of symptoms Essential Referral Content Referring
The Hip from Cradle to Grave. Haemish Crawford Ascot Hospital Starship Children s Hospital
The Hip from Cradle to Grave Haemish Crawford Ascot Hospital Starship Children s Hospital Developmental dysplasia hip DDH Irritable vs. septic hip Perthes disease Slipped Upper Femoral Epiphysis (SUFE)
The Diagnosis of Lupus
The Diagnosis of Lupus LUPUSUK 2017 This information booklet has been produced by LUPUS UK 2017 LUPUS UK LUPUS UK is the registered national charity for people with systemic lupus erythematosus (SLE) and
THE PATIENT PRESENTS WITH
THE PATIENT PRESENTS WITH 1. Fever or rash 3 2. Heart, lung or ENT problems 9 3. Gut or liver problems 19 4. Haematuria or proteinuria 27 5. Neurological problems 31 6. Musculoskeletal problems 37 7. Pallor,
Guideline on the clinical management of Henoch Schonlein Purpura (HSP)
Guideline on the clinical management of Henoch Schonlein Purpura (HSP) Purpose To ensure a standardised approach in the management of children with HSP in southern Derbyshire. Scope The scope of this guideline
APPROACH TO PATIENTS WITH POLYARTHRALGIA
APPROACH TO PATIENTS WITH POLYARTHRALGIA Scott Vogelgesang, MD Division of Immunology University of Iowa No conflicts of interest DEFINITIONS Arthralgia joint pain with no evidence of inflammation Arthritis
9/13/2015. Nothing to disclose
Jared Bozeman Kathleen Luskin MD Bipin Thapa MD Medical College of Wisconsin Milwaukee, Wisconsin Nothing to disclose 24 Year old previously healthy woman presenting from OSH Fatigue Weakness Neck swelling
CHAPTER 3. Secondary Glomerulonephritis
CHAPTER 3 Secondary Glomerulonephritis Rosnawati Yahya Liew Yew Foong 59 3.1: Introduction This chapter covers the main secondary glomerulonephritis that were reported to the MRRB from the year 2005-2010.
Pediatric Rheumatology Board Review
Pediatric Rheumatology Board Review Simona Nativ, MD Pediatric Rheumatology Goryeb Children s Hospital Question #1 A 2 year old male (pictured at left) presents with his mother who complains that his left
Henoch Schonlein Purpura
CHILDREN S SERVICES Henoch Schonlein Purpura Definition A vasculitic syndrome of small vessels classically characterised by a purpuric rash, abdominal pain, arthritis, and nephritis. Platelet count and
One Hundred and Seventy Cases of Childhood Onset Rheumatological Disease in Singapore
496 One Hundred and Seventy Cases of Childhood Onset Rheumatological Disease in Singapore Y See,*FAMS, MRCP (UK), M Med (Paed), E T Koh,**FAMS, M Med, MRCP (UK), M L Boey,***FAMS, M Med (Int Med), FRCP
Mohammad Reza Shakibi M.D Kerman university of medical sciences (KMU) Shafa Hospital, Rheumatology ward
VASCULITIS SYNDROMES Mohammad Reza Shakibi M.D Kerman university of medical sciences (KMU) Shafa Hospital, Rheumatology ward ILLUSTRATED CASE 1 A 56 years old lady refered me for prolonged fever, arthritis
DISEASES AND DISORDERS
DISEASES AND DISORDERS 9. 53 10. Rheumatoid arthritis 59 11. Spondyloarthropathies 69 12. Connective tissue diseases 77 13. Osteoporosis and metabolic bone disease 95 14. Crystal arthropathies 103 15.
Essential Rheumatology. Dr Ellen Bruce Consultant Rheumatologist CMFT
Essential Rheumatology Dr Ellen Bruce Consultant Rheumatologist CMFT Saving the best for last! Apparently people recall best the first and last thing they re told. Far too difficult to include everything.
Exclude referred pain from the neck, diaphragm, heart, lungs, & polymyalgia rheumatica YES. NSAIDs/analgesics as required
Shoulder Pain Clinical Presentation info for GPs who refer into PAH more info History and Examination Exclude referred pain from the neck, diaphragm, heart, lungs, & polymyalgia rheumatica more info for
MUSCULOSKELETAL VOL
MUSCULOSKELETL VOL. 1 1 MUSCULOSKELETL TBLE OF CONTENTS Musculoskeletal Neurology Psychology Cardiology Dermatology Endocrinology ENT Genitourinary Hematology Infectious Disease Ob-Gyn Ophthalmology Pulmonology
An understanding of the components of the normal gait cycle will aid in describing abnormalities of gait.
Approach to the Child with a Limp: Student writer: Brian Mayson Resident editor: Elmine Statham Background The child with a limp is a common problem seen in pediatrics. A limp is defined as any deviation
CHAPTER 3. Secondary Glomerulonephritis
2nd Report of the Malaysian Registry of Renal Biopsy 2008 SECONDARY GLOMERULONEPHRITIS CHAPTER 3 Secondary Glomerulonephritis Rosnawati Yahya Liew Yew Foong 41 SECONDARY GLOMERULONEPHRITIS 2nd Report
The Johns Hopkins Hospital
The Johns Hopkins Hospital 19901006 2016/03/21-04/20 (rheumatology) (emergecny medicine) (rheumatology consult team) attending Dr. Haque, R2 Dr. Michailidou, fellow Dr. Adler "She is a so interesting case.
PEDIATRICS 300A CORE TOPICS LIST
PEDIATRICS 300A CORE TOPICS LIST Symptom, finding, or concern Heart findings Core Innocent murmurs Extended Congestive heart failure Myocarditis PDA Valvular defects Cyanotic congenital heart disease Acyanotic
Diagnosis and Management of Common and Infective Skin Diseases in Children at primary care level
Diagnosis and Management of Common and Infective Skin Diseases in Children at primary care level Dr Ng Su Yuen Paediatrician and Paediatric Dermatologist Hospital Pulau Pinang Outline Common inflammatory
Vaccine reaction history
Questionnaire to consider partial or complete medical exemption from vaccination Vaccine reaction history This form should be copied and completed for each vaccine reaction, whether it is for the patient
Uncommon clinical presentations of leprosy: apropos of three cases
Lepr Rev (2016) 87, 246 251 CASE REPORT Uncommon clinical presentations of leprosy: apropos of three cases RASHMI JINDAL* & NADIA SHIRAZI** *Department of Dermatology, Venereology & Leprosy, Himalayan
Down Syndrome Ireland involved in life-changing research into arthritis
Down Syndrome Ireland involved in life-changing research into arthritis In 2013, Down Syndrome Ireland engaged with clinicians in Our Lady s Children s Hospital, Crumlin to investigate the increased incidence
*HSP is a common vasculitis of small vessels with cutaneous & systemic complications. Its etiology is unknown& often follows URTIs.
BY Introduction The disease is eponymously named after Eduard heinrich Henoch (1820-1910), a German pediatrician, and his teacher Johann Lukas Schonlein (1793-1864), who described it in the 1860s. Cont
AN APPROACH TO HEMATURIA. Dr Saima Ali
AN APPROACH TO HEMATURIA Dr Saima Ali Definition Microscopic hematuria hematuria is defined as the presence of 5 or more RBCs per high-power field in 3 of 3 consecutive centrifuged specimens obtained at
CPC. Chutika Srisuttiyakorn, M.D. Kobkul Aunhachoke, M.D. Phramongkutklao Hospital Bangkok, Thailand
CPC Chutika Srisuttiyakorn, M.D. Kobkul Aunhachoke, M.D. Phramongkutklao Hospital Bangkok, Thailand A 53 year-old woman with fever, facial swelling and rashes on face, trunk and upper extremities for 3
Treatment modalities Prof Ally 2012
Treatment modalities Prof Ally 2012 Analgesia Types of Pain Nociceptive /neuropathic nociceptive Tissue damage - trauma, inflammation Somatic (musculoskeletal): local pain referred pain Neuropathic pain:
Musculoskeletal pains in children are common, affecting 10% 20% of
Clinical basics Rheumatology: 16. Diagnosing musculoskeletal pain in children Peter N. Malleson, Richard D. Beauchamp The case A 7-year-old girl has a 2-month history of a mildly swollen and slightly painful
Emergency Dermatology. Emergency Dermatology
Emergency Dermatology These are rapidly progressive skin conditions and some are potentially lifethreatening. Early recognition is important to implement prompt supportive care and therapy. Some are drug
Features distinguishing juvenile idiopathic arthritis among children with musculoskeletal complaints
https://doi.org/10.1007/s12519-018-0212-0 ORIGINAL ARTICLE Features distinguishing juvenile idiopathic arthritis among children with musculoskeletal complaints Satita Jeamsripong 1 Sirirat Charuvanij 2
EXAMINATION OF HIP. A. Inspection Examination
EXAMINATION OF HIP History: What is your trouble? Pain, stiffness, limp Please tell me more about your problem?.listen Listen for at least one minute: Let patient do the talking Do not ask leading question
Haematological Cancer Suspected (Adults & Children)
Haematological Cancer Suspected (Adults & Children) Link to NICE guidelines: https://www.nice.org.uk/guidance/ng47 Patient of any age presents with symptoms of possible haematological cancer If 60 years
Disclosures. Rheumatological Approaches to Differential Diagnosis, Physical Examination, and Interpretation of Studies. None
Rheumatological Approaches to Differential Diagnosis, Physical Examination, and Interpretation of Studies Sarah Goglin MD Assistant Professor of Medicine Division of Rheumatology Disclosures None 1 [footer
Musculoskeletal Management of A Limping Child
Musculoskeletal Management of A Limping Child Julieanne P. Sees, DO, FAOAO Pediatric Neuro-Orthopaedic Surgeon Medical Director, Neuro-Orthopaedic Rehabilitation Unit Wilmington, DE Objectives Identify
The Health of X- linked CGD Carriers in the United Kingdom CGD Society Family Day, Oct 2015
The Health of X- linked CGD Carriers in the United Kingdom CGD Society Family Day, Oct 2015 Dr Alex Battersby Paediatric Registrar, Great North Children s Hospital Newcastle upon Tyne Outline of Presentation
Understanding Rheumatoid Arthritis
Understanding Rheumatoid Arthritis Understanding Rheumatoid Arthritis What Is Rheumatoid Arthritis? 1,2 Rheumatoid arthritis (RA) is a chronic autoimmune disease. It causes joints to swell and can result
Disclaimer. This is a broad survey and cannot cover all differential diagnoses or each condition in thorough detail
Objectives Pediatric Infections: Differentiating Benign from Serious Eileen Klein, MD, MPH Rashes Infectious vs non-infectious Viral vs bacterial Respiratory and GI illnesses When do you treat When do
PEDIATRIC RHEUMATOLOGY:A PRIMARY CARE PERSPECTIVE STEVE TRAVIS, MD, FAAP, FACP
PEDIATRIC RHEUMATOLOGY:A PRIMARY CARE PERSPECTIVE STEVE TRAVIS, MD, FAAP, FACP PEDIATRIC RHEUMATOLGY I I have no personal or financial conflicts of interest involving this presentation. I WILL BE discussing
Rheumatologic Manifestations of Gastrointestinal Diseases
Rheumatologic Manifestations of Gastrointestinal Diseases NATASHA DEHGHAN, MD, FRCPC CLINICAL ASSISTANT PROFESSOR VASCULITIS CLINIC, MARY PACK ARTHRITIS CENTRE Objectives To discuss a few common rheumatologic
Fever in children aged less than 5 years
Fever in children aged less than 5 years A fever is defined as a temperature greater than 38 degrees celsius Height and duration of fever do not identify serious illness. However fever in children younger
Inflammatory Myopathies 4 th year MBBS. Marwan Adwan MBChB, MSc, MRCPI, MRCP(rheum) Consultant Rheumatologist
Inflammatory Myopathies 4 th year MBBS Marwan Adwan MBChB, MSc, MRCPI, MRCP(rheum) Consultant Rheumatologist Case A 64 woman presents with erythematous itchy rash over back of hands & forehead. For 1 month
KAWASAKI DISEASE. What is Kawasaki disease? Causes
What is Kawasaki disease? Kawasaki disease is a form of vasculitis a family of rare disorders characterized by inflammation of the blood vessels, which can restrict blood flow and damage vital organs and
Bones? Did someone say bones? 12/31/2012. W.R Reinus, MD MBA FACR
William R. Reinus, MD MBA FACR Temple University Medical Center Aug 2012 (55) 1 Bones? Did someone say bones? 2 ABC S OF ARTHRITIS Arthritis: By definition, any disease that is jointcentered: Both sides
Skin Manifestations of Systemic Disease. Approach to Dermatalogic Diagnosis 9/6/2016. Go Ahead---Judge a Book by its Cover!
Go Ahead---Judge a Book by its Cover! Skin Manifestations of Systemic Disease Amelie Hollier, DNP, FNP-BC, FAANP Lafayette, LA President, APEA Objectives Compare diseases of the skin with reactions of
Developed by Stephanie Zachary, Sarah Weicker, Dr. Jeremy Friedman, Dr. Carolyn Beck, and Dr. Lauren Kitney for PedsCases.com.
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Primary Immune Thrombocytopenia (ITP) CPS Podcast These podcasts are designed to give medical students an overview of
Children s Hospital & Research Center Oakland Day Admit/Night Float
Children s Hospital & Research Center Oakland Day Admit/Night Float Patient Care Provide family-centered patient care that is development- and ageappropriate, compassionate, and effective for the treatment
Vasculitis Update. A selective review of what s new. Dr Jonathan Akikusa MBBS FRACP
Vasculitis Update A selective review of what s new Dr Jonathan Akikusa MBBS FRACP Consultant Paediatric Rheumatologist Royal Children s Hospital, Melbourne Honorary Research Fellow Murdoch Children s Research
Acquired Hip Disorders in Children and Adolescents. Sarah D. Bixby Department of Radiology Boston Children s Hospital Boston, MA
Acquired Hip Disorders in Children and Adolescents Sarah D. Bixby Department of Radiology Boston Children s Hospital Boston, MA Don t Miss Acquired Hip Disorders SCFE Posterior Hip Dislocation Osteoid
RHEUMATOLOGY PATIENT HISTORY FORM
!! RAMOS RHEUMATOLOGY, PC RHEUMATOLOGY PATIENT HISTORY FORM Date: / / NAME: Birthdate: / / Last First M. I. Age: Sex: F M Marital status: Never married Married Divorced Separated Widowed Partnered/significant