Episode 17: Rheumatology: A systematic approach to differentiating the various childhood arthritic conditions

Tolulope Fatola, MD and Julia F. Shalen, MD from Johns Hopkins Hospital discuss Rheumatology: A systematic approach to differentiating the various childhood arthritic conditions. Key takeaways:Core diagnostic cues and red flags for common pediatricrheumatic diseases discussed, with quick signs you can check on exam.Key physical exam findings and how to differentiateinflammatory vs. noninflammatory presentations in children (joints, skin, mucosal) to guide when to escalate.Initial workup steps and criteria for urgent rheumatology referral, including when to order imaging or labs.First-line treatment principles in pediatrics: NSAIDs,steroid-sparing approaches, and DMARDs/biologics, with pediatric dosing caveats and vaccine considerations.Monitoring and safety considerations for children onimmunomodulatory therapy (growth, infections, lab monitoring, long-term risks).Controversies or debated points raised in the episode (e.g., sequencing of DMARDs/biologics, use of steroids, steroid-sparing strategies) with succinct takeaways or guidelines mentioned.Practical clinical pearls and common pitfalls for residents(how to simplify complex cases, how to communicate with families, and what to document consistently).