Although Shriners Hospitals for Children are primarily known for the treatment of children with orthopedic problems and burns, many Shriners Hospitals also care for children with juvenile idiopathic arthritis (JIA) — formerly known as juvenile rheumatoid arthritis (JRA). In addition to helping make the initial diagnosis, Shriners Hospital for Children provide medical therapy, physical and occupational therapy, intensive rehabilitation, joint injections, and sometimes surgery to correct leg-length inequalities and joint replacements. Children as young as 1 year old can develop arthritis, so it is not just a disease of the elderly.
There have been extraordinary advances in the care of children with JIA in the last decade with the development of more effective medications called biologics. However, there are often delays in initiation of treatment due to the critical shortage of pediatric rheumatologist. There are currently only 242 board-certified pediatric rheumatologists in the United States. Currently eight states have no pediatric rheumatologist in practice.
Shriners Hospitals for Children are helping provide care in communities that do not have a pediatric rheumatologist. In some cases a pediatric rheumatologist will travel to one of our hospitals on a monthly basis. In other instances there may be a local pediatric rheumatologist available to see patients at a Shriners Hospital. Delay in diagnosis and initiation of treatment are associated with a poorer outcome. It is crucial to increase the availability of these services to children.
The Springfield Hospital participates in research by belonging to CARRA (Childhood Arthritis and Rheumatology Alliance). Our hospital is one of the 60 centers in the U.S. in the CARRAnet Registry, an observational retrospective and prospective cohort study that enrolls children and adolescents with major rheumatic diseases. The goal is to follow children long term so that outcomes can be determined and treatment improved. CARRA also works to develop protocols for treatment of all childhood rheumatic diseases.
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