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Pediatric Rheumatology

​​Our Rheumatologists can help create a comprehensive treatment plan for your child.

Arthritis and other rheumatic disease can cause pain, swelling and loss of motion at the joints. The skin, heart, lungs and other internal organs can also be involved.

Here are some of the diseases and conditions we treat:

  • Juvenile arthritis
  • Lupus

Juvenile arthritis

Arthritis is a disease that affects the joints (the parts where bones meet and move). When the immune system mistakenly attacks proteins in joint lining cells or cartilage it causes swelling, stiffness, and sometimes pain.

Longer term inflammation in the joint may cause permanent damage to joints in children. 

There are four main types of juvenile arthritis and many other illnesses that may be associated with arthritis such as inflammatory bowel disease, psoriasis, Lyme's and lupus. Marshfield Clinic has specialists in rheumatology who diagnose and treat arthritis.


Treatment of juvenile arthritis depends on the specific form of the disease a child is diagnosed with. A doctor will work with you to develop a treatment plan that could include any of the following:


  • Disease Modifying Anti Rheumatic Drugs (DMARD's) are frequently used to aim for a disease remission.
  • Biologic medications may be suggested for disease suppression.
  • Corticosteroids are drugs used as a bridge of treatment while waiting for other meds to begin working, but are usually not used as permanent drugs. If just one or a few joints are involved a cortisone injection may help turn off the inflammation locally and are given with the help of the pediatric sedation team.
  • NSAID - taken at low doses early, even prior to diagnosis of arthritis to control muscle aches, headaches and inflammation.


  • Therapeutic exercise (physical therapy) may be recommended to restore potentially lost muscle, increase a joint's range of motion and build up strength and endurance.
  • Recreation exercise like swimming or bike riding also helps to work out stiff joints and muscles while allowing for social interaction. We hope to return children to normal sports and recreation with modern therapy.

Surgery is rare in the treatment of juvenile arthritis. However, it can be used to relieve pain, correct a difference in length of a leg, straighten a bent or deformed joint, or replace a joint that is damaged.


Systemic lupus is a disease that causes your child's immune system to attack its own cells and tissues. 

This can affect your joints and organs, such as the skin, kidneys, joints, heart and lungs. The most common symptoms are pain, swelling and loss of function. 

It is an ongoing problem that can be serious, but it can be controlled by living a healthy, balanced lifestyle and regular visits to a doctor. 

Marshfield Clinic has specialists trained in the diagnosis and treatment of lupus in kids.


A rheumatologist will recommend a combination of medication and physical activity to reduce the symptoms of lupus. Often kidneys are involved and a nephrologist is involved in evaluation and treatment decisions as well.


  • Common pain-relief medications are available for the treatment of joint pain.
  • Antimalarial medications can be prescribed to help fight skin rashes and help prevent flairs.
  • Steroids may be recommended to fight symptoms of lupus.
  • Immunosuppressive drugs may be used to hold back the activity of the immune system and lessen the effects of the disease on important organ systems.

A team of medical professionals can work with a family to determine specific lifestyle changes to help control the onset of lupus. Some ideas could include:

  • Eating well and exercising regularly can also help a person avoid a flare up of the disease.
  • Rheumatologists recommend that people with lupus not spend time in the sun unless they wear sunscreen and protective clothing because ultraviolet rays may bring on a flare-up.
  • Kids with lupus should avoid smoking, drinking and drugs.​

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