The majority of this rotation will take place in a clinic setting and you will primarily be responsible for history, physical examination, laboratory/pathology interpretation, assessment and creating a management plan for patients.
In addition, you will evaluate patients in our infusion suite who are receiving IV medications.
If the opportunity arises, you may observe or perform an intra-articular steroid injection.
You will be observed directly by the attending physicians. The attendings provide oral and written evaluation at the conclusion of the rotation and whenever possible will provide verbal feedback during the rotation.
Conditions that are commonly evaluated include:
- juvenile idiopathic arthritis (JIA)
- systemic lupus erythematosus (SLE) and related systemic autoimmune disease
- systemic vasculitis
- inflammatory myopathies (IM)
- autoinflammatory syndromes
- pain syndromes
- Raynaud’s disease
During this rotation, you will learn how to:
- understand, recognize and report key clinical features in the history
- perform a comprehensive physical exam, particularly a detailed musculoskeletal exam, on children of all ages
- be able to interpret common laboratory tests used in patients with rheumatologic conditions — in particular inflammatory markers, ANA, RF, HLA-B27, ANCA, CCP antibodies, and other specific autoantibody testing
- recognize basic radiographic features of musculoskeletal disease, and interpret radiology assessments in the context of the clinical presentation
- synthesize and incorporate data obtained from history, exam, laboratory and imaging and develop a pertinent assessment and management plan.
- understand the clinical scenario where an arthrocentesis or intraarticular steroid injection is warranted, understand the basic procedure techniques and understand how to interpret synovial fluid analyses, and how the data helps aid in diagnoses of particular conditions
- understand the basics of treatments (specifically biologic agents and immune modulating agents) and therapies begin to understand specific dosing used, and understand the reasoning behind escalation or change of treatment
- understand how amplified musculoskeletal pain presents, and the approach to treatment and how it varies from other rheumatologic conditions
We will also teach you how to:
- understand how to interpret autoantibody testing in children
- describe the major clinical manifestations of rheumatologic conditions in children
- describe the pathogenic mechanisms of rheumatologic conditions including but not limited to JIA, SLE and related diseases, IM, scleroderma, autoinflammatory syndromes and vasculitis.
- describe the indications for laboratory tests that would be useful in the evaluation of rheumatologic conditions in children.
- be able to describe the basic treatment strategies for JIA, SLE and related diseases, IM, autoinflammatory syndromes, scleroderma and vasculitis
- be able to describe indications and interpretation of testing for rheumatologic conditions