Starship Paediatric Rheumatology

The Starship Paediatric Rheumatology service is primarily an outpatient service that sees patients in both the daystay unit and outpatient clinics at Starship.
The service is part of the New Zealand Paediatric Rheumatology service, providing specialised care for children and young people with arthritis and related conditions in the greater Auckland region, the upper North Island and the Far North.
The rheumatology team includes doctors, a clinical nurse specialist, physiotherapist and occupational therapist. They also work closely with other paediatric specialists when required.
 
What is Rheumatology?

Rheumatology is the specialty of medicine that includes arthritis and autoimmune diseases. The term arthritis refers to the inflammation of a joint in the body. An autoimmune disease is where an abnormality in the immune system leads to the body’s defence harming its own cells by mistake.

Common Conditions

Paediatric Rheumatology encompasses a wide variety of inflammatory and non-inflammatory conditions of the musculoskeletal system (muscles and joints) as well as conditions of non-infectious multi-system inflammation.

The types of conditions cared for by the Rheumatology team include:

  • Juvenile idiopathic arthirits (JIA)
  • Systemic lupus erythematosus (SLE)
  • Juvenile dermatomyositis (JDM)
  • Vasculitis
  • Connective tissue disease
  • Scleroderma
  • Chronic recurrent multifocal osteomyelitis (CRMO)

Consultants

  • Dr Sue Rudge, Rheumatologist
  • Dr Jacqueline Yan, Paediatric Rheumatologist

Hours

Monday, Tuesday and Thursday between 7.30am and 4.00pm

Referral Expectations

Your GP or paediatrician will refer your child to the Starship Paediatric Rheumatology service if they think your child may have arthritis or an autoimmune disease and they require a specialist opinion regarding the diagnosis or treatment of this condition. Before coming to the clinic your child may need to undergo some tests such as blood tests or x-rays, and it is helpful to bring a list of any medicines they are currently taking.

At the clinic appointment a history of your child's symptoms will be taken as well as a review of any medications they are on. Your child will then be examined, and may be referred for further testing. They may also be reviewed by other members of the multi-disciplinary team.
The specialist will discuss with you the possible diagnosis and what further tests or treatments are recommended. They will also contact your GP about the diagnosis, results of tests and a treatment plan. Your child may have ongoing follow-up care in our clinic, or be discharged back to the care of your GP.

Common Conditions / Procedures / Treatments

Blood tests

Blood tests can be used to look for how much inflammation there is in the body, monitor certain side effects of the medicines the patient is taking and/or help classify the patient's rheumatological condition.

X-rays

X-rays are used to give a picture of the bones and joints. An x-ray can help to check the position and condition of the bones near a joint.

MRI

MRI (Magnetic Resonance Imaging) gives even more detailed pictures of joints and organs and may be helpful to check if the joint is damaged. Occasionally, if more detailed information about the joints is required, a dye is injected into the vein to show more detail in the picture.

Joint injections

A joint injection is most often done to deliver medicine directly into the joint. This may be done when the other medication the patient is taking is not controlling the arthritis well enough or if the patient has just one swollen joint. In older children the joint injections are done with the child inhaling laughing gas (nitrous oxide) which helps relieve the discomfort of the procedure.

Drug infusions

Some medications used in rheumatology are given as an infusion. These can be steroids and some of the biologic agents.

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