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Rheumatic conditions impact more than a child’s joints. Related symptoms can affect physical growth, school performance, and family dynamics. Our specialists work with parents and the child’s support system to minimize the condition’s impact and provide support for the entire family. By offering a team of medical experts within one organization, we provide comprehensive treatment that is convenient for patients, families and health-care providers. We see patients at Eccles Primary Children's Outpatient Services building and at PCH Outpatient Services at Riverton clinic locations.


We Provide Consultation & Treatment for:

  • Juvenile arthritis
  • Dermatomyositis
  • Periodic fever and other autoinflammatory disorders
  • Scleroderma and morphea
  • Systemic lupus erythematosus
  • Vasculitis

Contact Us

801-213-3599

Juvenile Arthritis and Other Rheumatic Diseases

What are juvenile arthritis and other rheumatic diseases?

Arthritis is an inflammation of the joints that causes pain and swelling. Juvenile arthritis is the term used for arthritis in children. The most common form of juvenile arthritis is juvenile idiopathic arthritis (JIA), also called juvenile rheumatoid arthritis (JRA).  

Arthritis is a group of more than 100 diseases. It’s only one category of rheumatic diseases. Rheumatic diseases can cause pain, stiffness, and swelling in the joints, and bones. Rheumatic diseases can also affect other areas of the body, including organs. Some rheumatic diseases affect connective tissues. These types of tissues include muscles, tendons, and ligaments. The diseases are known as connective tissue diseases. Other types of diseases are caused by the body's immune system attacking its own healthy cells and tissues. These are known as autoimmune disorders.

What causes juvenile arthritis and other rheumatic diseases?

Experts don’t know what causes juvenile arthritis and most types of rheumatic diseases. In many cases, the cause may vary depending on the type of disease. Certain factors that may play a part in one or more types of these diseases include:

  • The immune system
  • Genes and family history
  • Injury
  • Infection
  • Nervous system problems
  • Metabolic problems
  • Excessive wear and tear and stress on the body
  • Environmental triggers
  • The effect of some hormones on the body

Who is at risk for juvenile arthritis and other rheumatic diseases?

Juvenile arthritis and rheumatic diseases can affect children of any age and any ethnic background. But some types are more common in some children, such as:

  • Juvenile rheumatoid arthritis (JRA). This condition more often affects children younger than age 15.
  • Systemic lupus erythematosus (lupus). This occurs more often in girls.
  • Ankylosing spondylitis (AS). This bone disease is more common in boys.

What are the symptoms of juvenile arthritis and other rheumatic diseases?

Each type of rheumatic diseases has its own set of symptoms. And symptoms can occur a bit differently in each child. But the most common symptoms in all the diseases include:

  • Joint pain
  • Swelling in 1 or more joints
  • Joint stiffness that lasts for at least 1 hour in the early morning
  • Chronic pain or tenderness in the joints
  • Warmth and redness in the joint area
  • Limited movement in the affected joints
  • Extreme tiredness (fatigue)
  • Fevers that don't go away, or that come back

These symptoms may seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How are juvenile arthritis and other rheumatic diseases diagnosed?

The process starts with a medical history and a physical exam. Tests may also be done. These include blood tests such as:

  • Antinuclear antibody (ANA) test. This checks the levels of antibodies in the blood.
  • Complete blood count (CBC). This is done to see if white blood cell, red blood cell, and platelet levels are normal.
  • Creatinine. This checks for kidney disease.
  • Sedimentation rate. This can detect inflammation.
  • Hematocrit. This test measure the number of red blood cells.
  • Rheumatoid factor test. This test checks to see if rheumatoid factor is present in the blood.
  • White blood cell count. This can determine the level of white blood cells in the blood.
  • Uric acid. This can help diagnosis gout.

Other tests may be done, such as:

  • Joint aspiration (arthrocentesis). A small sample of the synovial fluid is taken from a joint. It's tested to see if crystals, bacteria, or viruses are present.
  • X-rays or other imaging tests. These are done look at the extent of damage to a joint.
  • Urine test. This is done to check for protein and various kinds of blood cells.
  • HLA tissue typing. This is done to look for genetic markers of ankylosing spondylitis.
  • Skin biopsy. Tiny pieces of tissue are taken to check under a microscope. This helps to diagnose a type of arthritis that involves the skin, such as lupus or psoriatic arthritis.
  • Muscle biopsy. Tiny pieces of tissue are taken to check under a microscope. This helps to diagnose conditions that affect muscles. These include polymyositis or vasculitis.

How are juvenile arthritis and other rheumatic diseases treated?

Treatment will depend on your child's symptoms, age, and general health. It will also depend on what type of disease your child has, and how severe the condition is. A treatment plan is tailored to your child with his or her healthcare team. The healthcare team will include your child's primary healthcare provider. It will also include a rheumatologist, orthopedist, physical therapist, and other healthcare providers.

There is no cure for most juvenile arthritis and other rheumatic diseases. The goal of treatment is often to limit pain and inflammation, and help ensure joint function. Certain organs, such as the eyes and heart, are also checked often for problems. Treatment plans often use both short-term and long-term methods.

Short-term treatments include:

  • Medicines. Short-term relief for pain and inflammation may include pain relievers such as acetaminophen, ibuprofen, or other nonsteroidal anti-inflammatory medicines. Talk with your child's healthcare provider before giving any of these medicines to your child.
  • Heat and cold. Pain may be eased by using moist heat (warm bath or shower) or dry heat (heating pad) on the joint. Pain and swelling may be eased with cold (ice pack wrapped in a clean, thin towel) on the joint.
  • Joint immobilization. Using a splint or brace can help a joint rest and protect it from further injury.
  • Massage. Lightly massaging painful muscles may increase blood flow and bring warmth to the muscle.

Long-term treatments include:

  • Disease-modifying antirheumatic drugs (DMARDs). These medicines may slow down the disease and treat any immune system problems linked to the disease. Examples of these medicines include methotrexate, penicillamine, and gold injections.
  • Corticosteroids. These medicines, such as prednisone, reduce inflammation and swelling. They can be taken by mouth or as an injection.
  • Biologics. These are medicines to help stop the inflammation process in the body. These include etanercept, golimumab, infliximab, and others.
  • Weight loss. Extra weight puts more stress on joints such as the hips and knees.
  • Exercise. Certain exercises may help reduce joint pain and stiffness. These include swimming, walking, low-impact aerobic exercise, and range-of-motion exercises. Stretching may also help keep the joints flexible.
  • Use of assistive devices. Canes, crutches, and walkers can help to keep stress off certain joints and to improve balance.
  • Surgery. In severe cases of disease, surgery may be needed to fix or replace a joint. There are 2 main types of surgery: repair and replacement. Surgery to repair a damaged joint may include removing debris in the joint, fusing bones, or correcting a bone deformity. If a joint is too damaged for repair, it may need to be replaced with an artificial joint.

What are the complications of juvenile arthritis and other rheumatic diseases?

If only a few joints are affected, arthritis may cause little or no joint damage. Some children may have chronic pain and disability. Other complications include slowed growth, anemia, and problems with the eyes or heart.

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Helping your child live with juvenile arthritis and other rheumatic diseases

Help your child manage his or her symptoms by sticking to the treatment plan. Encourage exercise and physical therapy. Find ways to make it fun. Work with your child’s school to make sure your child has help as needed. Work with other caregivers to help your child take part as much possible in school, social, and physical activities. Your child may also qualify for special help under Section 504 of the Rehabilitation Act of 1973. You can also help your child find a support group to be around with other children with similar health conditions.

When should I call my child’s healthcare provider?

If your child’s symptoms get worse or he or she has new symptoms, let the healthcare provider know.

Key points about juvenile arthritis and other rheumatic diseases

  • Arthritis is an inflammation of the joints that causes pain and swelling. Juvenile arthritis is the term used for arthritis in children.
  • Arthritis is one type of rheumatic disease. Arthritis affects joints, muscles, tendons, ligaments, and bones. Rheumatic diseases can affect other body parts. These include organs such as the heart and eyes.
  • Common symptoms include joint pain, swelling, stiffness, and warmth.
  • Experts don’t know what causes juvenile arthritis and most types of rheumatic diseases.
  • Treatment options include medicines, heat and cold, massage, exercise, physical therapy, and surgery.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

John F. Bohnsack, M.D.

John Bohnsack MD graduated from Yale College, and received his medical degree from the University of Virginia. He is board certified in Pediatrics and in Pediatric Rheumatology. He is a Professor of Pediatrics and has been a member of the faculty of the University of Utah School of Medicine for 22 years. Dr. Bohnsack’s clinical interests incl... Read More

Specialties:

Pediatric Immunology, Pediatric Rheumatology

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 213-3599
PCH Outpatient Services at Riverton (801) 213-3599

Sylvia Boulva, M.H.S., PA-C

Sylvie Fadrhonc, MHS, PA-C received her Bachelor of Arts in Geology and Pre-Medical Sciences from Colorado College, graduating with honors in 2007. During her undergraduate studies, Sylvie worked as an athletic trainer with the Colorado College Sports Medicine Department, designing and implementing physical therapy programs for student athletes. In... Read More

Specialties:

Pediatric Immunology, Pediatric Rheumatology

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 213-3599
PCH Outpatient Services at Riverton (801) 213-3599

Deborah Durkee, APRN

Debbie Durkee received a Bachelor of Science in Family and Human Development from Utah State University in 1997. She then began working in the Behavioral Health Unit at Primary Children’s Medical Center as a Behavioral Health Specialist and Social Service Worker. In April 2003 she completed her LPN degree at Davis Applied Technology College and be... Read More

Specialties:

Pediatric Immunology, Pediatric Rheumatology

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 213-3599
PCH Outpatient Services at Riverton (801) 213-3599

Aimee O. Hersh, M.D.

Dr. Aimee Hersh received her medical degree from Brown Medical School and completed her residency and clinical fellowship in Pediatric Rheumatology at University of California, San Francisco. She is currently an Assistant Professor in Pediatric Rheumatology at the University of Utah School of Medicine and Primary Children’s Medical Center. As a ... Read More

Specialties:

Pediatric Rheumatology

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 213-3599
PCH Outpatient Services at Riverton (801) 213-3599

Christi J. Inman, M.D., M.S.

CJ Inman, MD, MS is an Assistant Professor in Pediatric Rheumatology at the University Of Utah School Of Medicine and Primary Children’s Medical Center. She received her medical degree from Drexel School of Medicine, completed her pediatric residency at the University of California at Irvine and her pediatric rheumatology fellowship at the Seattle ... Read More

Specialties:

Medical Informatics, Pediatric Rheumatology

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 213-3599
PCH Outpatient Services at Riverton (801) 213-3599

Karen James, M.D.

Dr. Karen James received her medical degree from Tufts University School of Medicine. She completed her Pediatrics residency at Golisano Children’s Hospital at the University of Rochester, and her Pediatric Rheumatology fellowship at the Children’s Hospital of Philadelphia. She is currently an Instructor in Pediatric Rheumatology at the University ... Read More

Sara Stern, M.D.

Dr. Sara Stern received her medical degree from Albert Einstein College of Medicine. She then completed her residency and a clinical fellowship in pediatric rheumatology at Children’s Hospital Los Angeles. She is currently an Assistant Professor in the Division of Pediatric Immunology, Rheumatology, and Allergy at the University of Utah School of... Read More

Specialties:

Pediatric Rheumatology

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 213-3599
PCH Outpatient Services at Riverton (801) 213-3599

Amy L. Woodward, M.D., M.P.H.

Dr. Woodward is an Associate Professor in the Division of Pediatric Allergy, Immunology and Rheumatology at the University of Utah School of Medicine and Primary Children’s Medical Center. Dr. Woodward received her medical degree from Vanderbilt University School of Medicine, after which she completed her residency in Pediatrics at the Children’s ... Read More

Specialties:

Pediatric Rheumatology

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 213-3599
PCH Outpatient Services at Riverton (801) 213-3599
PCH Outpatient Services at Riverton 3773 West 12600 South
Riverton, UT 84065
Appointments
801-213-3599
Eccles Primary Children's Outpatient Services 81 N. Mario Capecchi Dr.
Salt Lake City, UT 84113
Map
Appointments
801-662-1000