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Grand Rounds: The Rheum Where It Happens: Pearls for the Primary Care Provider

12-16-2022

By Christine Bacha, MD, RhMSUS , Pediatric Rheumatologist, Akron Children's Hospital, Akron, OH

Rheumatology

More about Christine Bacha, MD, RhMSUS


Objectives (Educational Content) :

1. Develop differential diagnoses for a pediatric patient with joint pain. 2. Recognize the signs and symptoms of lupus and implement an initial workup for this disease. 3. Provide anticipatory guidance to pediatric patients with autoimmune diseases on immuno-suppressive medication, including immunization recommendations and teratogenicity.

Target Audience:

General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists, and nurses.

Identified Gap:

Improvements in diagnosis and treatment of pediatric patients with autoimmune disorders.

Estimated Time to Complete the Educational Activity:

1 hour(s)

Expiration Date for CE/CME Credit:

12-15-2023

Method of Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CE/CME credit.

Disclosure:

The speaker, Christine Bacha, MD, has returned the disclosure form indicating there are no relevant financial or other relationships with any commercial interests.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit TM.  Physicians should only claim the credit commensurate with the extent of their participation in the activity.

Bibliography:

Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400-1412. Doi: 10.1002 art.40930. Epub 2019 Aug 6. PMID:31385462; PMCID:PMC 6827566.

Curtis JR, Johnson SR, Anthony DD, Arasaratnam RJ, Baden LR, Bass AR, et al. American College of Rheumatology Guidance for COVID-19 Vaccination in Patients with Rheumatic and Musculoskeletal Diseases – Version 5. Arthritis Rheumatol 2022 e1-e16. doi:https://onlinelibrary.wiley.com/doi/10.1002/art.42372

Foster HE, Jandial S. pGALS - paediatric Gait Arms Legs and Spine: a simple examination of the musculoskeletal system. Pediatr Rheumatol Online J. 2013 Nov 12;11(1):44. doi: 10.1186/1546-0096-11-44. PMID: 24219838; PMCID: PMC4176130.

Klein-Gitelman, M., & Beresford, M. (2019). Systemic Lupus Erythematosus, Mixed Connective Tissue Disease, and Undifferentiated Connective Tissue Disease. In R. Petty, R. Laxer, C. Lindsley, L. Wedderburn, E. Mellins, & R. Fuhlbrigge (Eds.), Textbook of Pediatric Rheumatology (8th ed., pp. 295-329). Elsevier.

Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm. J Bone Joint Surg Am. 1999 Dec;81(12):1662-70. doi: 10.2106/00004623-199912000-00002. PMID: 1060837

LeBlanc, C., & Houghton, K. (2019). Noninflammatory Musculoskeletal Pain. In R. Petty, R. Laxer, C. Lindsley, L. Wedderburn, E. Mellins, & R. Fuhlbrigge (Eds.), Textbook of Pediatric Rheumatology (8th ed., pp. 665-683). Elsevier.

Lyme disease data and surveillance. Center for Disease Control and Prevention. Retrieved December 11, 2022, from https://www.cdc.gov/lyme/datasurveillance/lyme-disease-maps.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Flyme%2Fdatasurveillance%2Fmaps-recent.html

Ringold, S., & Horneff, G. (2019). Oligoarticular Juvenile Idiopathic Arthritis. In R. Petty, R. Laxer, C. Lindsley, L. Wedderburn, E. Mellins, & R. Fuhlbrigge (Eds.), Textbook of Pediatric Rheumatology (8th ed., pp. 241-249). Elsevier.

Zemel, L., & Bockenstedt, L. (2019). Lyme arthritis. In R. Petty, R. Laxer, C. Lindsley, L. Wedderburn, E. Mellins, & R. Fuhlbrigge (Eds.), Textbook of Pediatric Rheumatology (8th ed., pp. 602-612). Elsevier.

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