Dr Pilkington
Juvenile arthritis, otherwise known as paediatric rheumatic disease, is a term used to describe a number of autoimmune and inflammatory diseases that can develop in children. The tissue on the inside of the joints (synovium tissue) can become inflamed due to a fault with the autoimmune system, which usually protects the body, where the immune system attacks the synovium tissue.
Juvenile arthritis is idiopathic, meaning no cause is known, though it is thought to be genetic, or triggered by certain infections or environmental triggers though no evidence has been discovered to support this.
There are a number of different types of juvenile arthritis, each with differing symptoms. Common symptoms include:
Juvenile idiopathic arthritis (JIA) is the most common form of arthritis found in children. This type of arthritis can appear in five different forms. These are:
Though there is no cure for juvenile arthritis, it can be treated until it goes into remission, and many forms of juvenile arthritis don’t last into adulthood. Treatment options include medication, physical activity, healthy eating and taking good care of the eyes if they become affected.
Lupus is a disease that damages the immune system; that is, your own immune system mistakenly attacks healthy cells and tissues. This can cause damage to many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.
There are different types of lupus:
We have not yet found a cure for lupus; a disease that can still be fatal for some. However, if treatment is successful it is rare for a person to die from lupus. Around 80-90% of people diagnosed with lupus live for more than 10 years after learning they have the disease. In addition, people who have some organs affected by the disease, but whose life is not at risk, usually live a completely normal life if they follow the advice of their specialist, which is to take prescription medications and to seek help if there are undesirable side-effects, or if new symptoms of the disease appear.
Lupus can have a variety of symptoms depending on the individual. The most common symptoms are:
These symptoms can be intermittent and are referred to as “outbreaks”. These outbreaks may be mild or severe and new symptoms may appear at any time.
As with the symptoms, there is no single test to diagnose lupus, because it can sometimes be confused with other diseases. It can take months or years for a specialist to diagnose lupus. Some of the medical tests that the specialist may use to diagnose lupus include:
The cause of lupus and its risk factors are currently unknown. Anyone can get lupus, but women are at a higher risk for the disease. Lupus is two to three times more common in African-American women than in white women. Hispanic, Asian and Native American women are also more likely to develop lupus. African-American and Hispanic women are more susceptible to the most severe types of lupus.
Lupus can occur without any symptoms, so it is difficult to know if it can be completely prevented during a person's lifetime. The best thing you can do to reduce the chances of developing lupus is to follow a balanced diet and to exercise regularly, i.e. have a healthy lifestyle.
There is no treatment to cure lupus, but medication and lifestyle changes can help control the disease. The aims of each treatment are to:
Treatments may be accompanied by medication for:
In addition to taking medicine for lupus, you may need to take medicine for other problems related to lupus, such as high cholesterol levels, high blood pressure, or infections. There are alternative treatments that take a completely different path to conventional treatments. However, there is currently no medical research regarding current, useful alternative therapies to combat lupus. Some alternative or complementary approaches may help improve the quality of life of those with a chronic illness like this. Before undertaking any alternative treatment, you should consult a specialist.
People with lupus will see several different doctors. Including, a primary care doctor, dermatologists, cardiologists, pain specialists, to name a few.
Dermatomyositis is a disease characterized by inflammation of the muscles and the presence of skin rashes. Symptoms may include pain and stiffness in muscles, muscle weakness, difficulty breathing, difficulty swallowing food, and rashes. The treatment includes taking corticosteroids and drugs that suppress the immune system, as well as doing moderate exercise. If the condition is associated with cancer, known as paraneoplastic dermatomyositis, the solution is to remove the tumour. There is also a version of this disease that affects children, called juvenile dermatomyositis.
Arthritis is a disease that causes inflammation of the membrane that covers the joints. There are more than 100 different types of arthritis, but the most common are:
The symptoms of arthritis can be:
This pathology can be a consequence of:
Joint damage can be prevented with timely and adequate diagnosis and treatment. Also, if someone has a family history it is important to talk with the doctor, even if s/he does not have any symptoms. It is also recommended to avoid repetitive and excessive movements to prevent osteoarthritis.
The treatment aims to alleviate the symptoms and prevent the disease from getting worse. The treatment can be covered by several aspects:
Joint hypermobility, also called hypermobility or Ehlers-Danlos syndrome is a hereditary disorder that occurs when a person has greater flexibility in joints, tendons, muscles and cartilage.
This disorder can produce symptoms such as the following:
The exact cause of joint hypermobility is unknown, however, it has been confirmed that genetics play a major role. It is thought that a genetic mutation in the collagen fibres that affect the elasticity of tendons, ligaments, the skin and blood vessels causes the condition. Hypermobile joints are often referred to as loose joints and those with the condition are referred to as being “double jointed”.
As the disorder is genetic in nature, it cannot be prevented, but complications can be avoided. Exaggerated flexion of the wrists or joints in the fingers should be avoided, that is, the fingers and the wrists shouldn’t be overextended or cracked. High-impact exercises should also be avoided.
Currently, there is no specific cure, but the effects can be mitigated with drugs (analgesics and non-steroidal anti-inflammatory drugs) and low-impact exercises, such as yoga or swimming. Improving muscle strength to protect the joints is vital, so your doctor may recommend occupational therapy or physiotherapy sessions to help with symptoms. You can also take home measures to reduce pain and stiffness by keeping joints warm, such as having warm baths and using deep heat creams.
Pain management is an interdisciplinary branch of medicine, which aims to improve quality of life for patients with chronic pain by reducing their suffering. It aims to relieve long-term pain, and may be administered by a single doctor, or a pain management team, consisting of different specialists. It can involve pharmacological or psychological treatments, or a combination of both.
While many branches of medicine focus on diagnosing and treating injuries and pathologies and treating the symptoms and pain during the healing process, pain management is needed when the pain persists after the injury or disease has healed. If the cause of the pain is not clear, relieving it becomes the objective. Patients with chronic (long-term) pain are the usual recipients. Types of pain that often require management include chronic back pain and headaches.
There are many types of treatments to manage pain, which can be roughly divided into three categories: physical, psychological, and medicinal.
Physical treatments include physiotherapy, therapeutic physical exercise, the application of heat and/or ice, acupuncture, electrotherapy, and various interventional procedures, such as facet joint injections and spinal cord stimulation. Different sufferers may find different things help relieve their pain, such as massage therapy. Some treatments may have a psychological element, including the placebo effect.
Psychological treatments, such as cognitive behavioural therapy (CBT) and hypnosis have been used to treat pain, with varying reports on the efficacy. Studies have shown a small improvement in mood after CBT, but there is insufficient evidence to definitively say that it relieves pain. Similarly, studies on the effects of hypnosis have been limited, but shows signs of improvement. Some believe it the effectiveness of psychological treatments may be based on the placebo effect.
Medicinal treatments involves different kinds of drugs – mainly painkillers and anti-inflammatories. The type of drug depends on the location, severity, and probable cause of the pain. For example, mild pain can be managed with over-the-counter painkillers, while severe pain (after injury or surgery, for example) may be treated with opioids. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, and for conditions like fibromyalgia, antidepressants may be prescribed.
Due to the multi-disciplinary nature of the specialty, a pain management team can consist of medical practitioners, nurse practitioners, physiotherapists, psychologists, and other mental health therapists.
Dr Clarissa Pilkington is one of London's leading rheumatologists. Specialising in paediatric rheumatology, systemic lupus erythematosus, juvenile dermatomyositis, juvenile arthritis, hypermobility and pain syndromes she is based at University College Hospital and Great Ormond Street Hospital. She is President of the British Society for Paediatric and Adolescent Rheumatology (BSPAR) and is a founding member of the UK paediatric Systemic Lupus Erythematosus study group, through which she has been dedicated to advancing medical knowledge in this area.
Arthritis is a disease that causes inflammation of the membrane that covers the joints. There are more than 100 different types of arthritis, but the most common are:
The symptoms of arthritis can be:
This pathology can be a consequence of:
Joint damage can be prevented with timely and adequate diagnosis and treatment. Also, if someone has a family history it is important to talk with the doctor, even if s/he does not have any symptoms. It is also recommended to avoid repetitive and excessive movements to prevent osteoarthritis.
The treatment aims to alleviate the symptoms and prevent the disease from getting worse. The treatment can be covered by several aspects:
Dermatomyositis is a disease characterized by inflammation of the muscles and the presence of skin rashes. Symptoms may include pain and stiffness in muscles, muscle weakness, difficulty breathing, difficulty swallowing food, and rashes. The treatment includes taking corticosteroids and drugs that suppress the immune system, as well as doing moderate exercise. If the condition is associated with cancer, known as paraneoplastic dermatomyositis, the solution is to remove the tumour. There is also a version of this disease that affects children, called juvenile dermatomyositis.
Joint hypermobility, also called hypermobility or Ehlers-Danlos syndrome is a hereditary disorder that occurs when a person has greater flexibility in joints, tendons, muscles and cartilage.
This disorder can produce symptoms such as the following:
The exact cause of joint hypermobility is unknown, however, it has been confirmed that genetics play a major role. It is thought that a genetic mutation in the collagen fibres that affect the elasticity of tendons, ligaments, the skin and blood vessels causes the condition. Hypermobile joints are often referred to as loose joints and those with the condition are referred to as being “double jointed”.
As the disorder is genetic in nature, it cannot be prevented, but complications can be avoided. Exaggerated flexion of the wrists or joints in the fingers should be avoided, that is, the fingers and the wrists shouldn’t be overextended or cracked. High-impact exercises should also be avoided.
Currently, there is no specific cure, but the effects can be mitigated with drugs (analgesics and non-steroidal anti-inflammatory drugs) and low-impact exercises, such as yoga or swimming. Improving muscle strength to protect the joints is vital, so your doctor may recommend occupational therapy or physiotherapy sessions to help with symptoms. You can also take home measures to reduce pain and stiffness by keeping joints warm, such as having warm baths and using deep heat creams.
Juvenile arthritis, otherwise known as paediatric rheumatic disease, is a term used to describe a number of autoimmune and inflammatory diseases that can develop in children. The tissue on the inside of the joints (synovium tissue) can become inflamed due to a fault with the autoimmune system, which usually protects the body, where the immune system attacks the synovium tissue.
Juvenile arthritis is idiopathic, meaning no cause is known, though it is thought to be genetic, or triggered by certain infections or environmental triggers though no evidence has been discovered to support this.
There are a number of different types of juvenile arthritis, each with differing symptoms. Common symptoms include:
Juvenile idiopathic arthritis (JIA) is the most common form of arthritis found in children. This type of arthritis can appear in five different forms. These are:
Though there is no cure for juvenile arthritis, it can be treated until it goes into remission, and many forms of juvenile arthritis don’t last into adulthood. Treatment options include medication, physical activity, healthy eating and taking good care of the eyes if they become affected.
Lupus is a disease that damages the immune system; that is, your own immune system mistakenly attacks healthy cells and tissues. This can cause damage to many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.
There are different types of lupus:
We have not yet found a cure for lupus; a disease that can still be fatal for some. However, if treatment is successful it is rare for a person to die from lupus. Around 80-90% of people diagnosed with lupus live for more than 10 years after learning they have the disease. In addition, people who have some organs affected by the disease, but whose life is not at risk, usually live a completely normal life if they follow the advice of their specialist, which is to take prescription medications and to seek help if there are undesirable side-effects, or if new symptoms of the disease appear.
Lupus can have a variety of symptoms depending on the individual. The most common symptoms are:
These symptoms can be intermittent and are referred to as “outbreaks”. These outbreaks may be mild or severe and new symptoms may appear at any time.
As with the symptoms, there is no single test to diagnose lupus, because it can sometimes be confused with other diseases. It can take months or years for a specialist to diagnose lupus. Some of the medical tests that the specialist may use to diagnose lupus include:
The cause of lupus and its risk factors are currently unknown. Anyone can get lupus, but women are at a higher risk for the disease. Lupus is two to three times more common in African-American women than in white women. Hispanic, Asian and Native American women are also more likely to develop lupus. African-American and Hispanic women are more susceptible to the most severe types of lupus.
Lupus can occur without any symptoms, so it is difficult to know if it can be completely prevented during a person's lifetime. The best thing you can do to reduce the chances of developing lupus is to follow a balanced diet and to exercise regularly, i.e. have a healthy lifestyle.
There is no treatment to cure lupus, but medication and lifestyle changes can help control the disease. The aims of each treatment are to:
Treatments may be accompanied by medication for:
In addition to taking medicine for lupus, you may need to take medicine for other problems related to lupus, such as high cholesterol levels, high blood pressure, or infections. There are alternative treatments that take a completely different path to conventional treatments. However, there is currently no medical research regarding current, useful alternative therapies to combat lupus. Some alternative or complementary approaches may help improve the quality of life of those with a chronic illness like this. Before undertaking any alternative treatment, you should consult a specialist.
People with lupus will see several different doctors. Including, a primary care doctor, dermatologists, cardiologists, pain specialists, to name a few.
Pain management is an interdisciplinary branch of medicine, which aims to improve quality of life for patients with chronic pain by reducing their suffering. It aims to relieve long-term pain, and may be administered by a single doctor, or a pain management team, consisting of different specialists. It can involve pharmacological or psychological treatments, or a combination of both.
While many branches of medicine focus on diagnosing and treating injuries and pathologies and treating the symptoms and pain during the healing process, pain management is needed when the pain persists after the injury or disease has healed. If the cause of the pain is not clear, relieving it becomes the objective. Patients with chronic (long-term) pain are the usual recipients. Types of pain that often require management include chronic back pain and headaches.
There are many types of treatments to manage pain, which can be roughly divided into three categories: physical, psychological, and medicinal.
Physical treatments include physiotherapy, therapeutic physical exercise, the application of heat and/or ice, acupuncture, electrotherapy, and various interventional procedures, such as facet joint injections and spinal cord stimulation. Different sufferers may find different things help relieve their pain, such as massage therapy. Some treatments may have a psychological element, including the placebo effect.
Psychological treatments, such as cognitive behavioural therapy (CBT) and hypnosis have been used to treat pain, with varying reports on the efficacy. Studies have shown a small improvement in mood after CBT, but there is insufficient evidence to definitively say that it relieves pain. Similarly, studies on the effects of hypnosis have been limited, but shows signs of improvement. Some believe it the effectiveness of psychological treatments may be based on the placebo effect.
Medicinal treatments involves different kinds of drugs – mainly painkillers and anti-inflammatories. The type of drug depends on the location, severity, and probable cause of the pain. For example, mild pain can be managed with over-the-counter painkillers, while severe pain (after injury or surgery, for example) may be treated with opioids. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, and for conditions like fibromyalgia, antidepressants may be prescribed.
Due to the multi-disciplinary nature of the specialty, a pain management team can consist of medical practitioners, nurse practitioners, physiotherapists, psychologists, and other mental health therapists.
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Dr Pilkington is very approachable and very thorough. She explained everything to us and answered all of our questions.