When you hear the term “arthritis,” you’ve been conditioned to picture an older adult. Who hasn’t seen a rheumatoid arthritis commercial with an older man or woman talking about their pain and the effectiveness of whatever particular medication is being sold? Although most forms of arthritis generally are associated with older adults, juvenile rheumatoid arthritis and childhood arthritis are very real conditions that can have a large impact on a child’s life. There are treatments available, but there aren’t exactly a lot of rheumatologists in our area that specialize in pediatric rheumatology. Blount Memorial rheumatologist Dr. Brett Smith just happens to be among them.
“Kids can be affected by autoimmune disease at any age from birth to age 18,” Smith said. “Autoimmune diseases before age 2 are fairly rare, but become more common from age 2 and older. They can develop at any time in a child's life, though, so parents need to be alert to the possibility of any new symptoms. Children who experience these conditions can have joint pain, joint swelling, rashes, fevers, vision changes, an inability to socialize with their family and friends, different leg lengths, impaired growth, weight gain and personality changes, most of which usually are reversible,” he explained. “When we diagnose a child with one of these diseases, we have to realize that children are not just little adults. Their bodies tend to act differently than adults’ bodies when they are sick. If a child has an autoimmune disease, he or she may have non-specific signs such as not wanting to bear weight on one leg, a fever, nighttime pain, a swollen joint or a positive blood test. Usually, the child's parent and pediatrician will note something generally is wrong, and then a rheumatologist can help make the right diagnosis,” he added.
Smith says there are some additional key warning signs to look for in children. “In addition to things like weight loss, nighttime pain and swollen joints, you also want to keep an eye out for new rashes, a red or painful eye, fatigue, or children falling off the growth chart,” he said. “Sometimes, we see children who maybe had positive blood tests and abnormalities on physical exams, but actually experience minimal symptoms or no symptoms at all. Still, it’s important in those situations that the child is seen for treatment, even if his or her symptoms are minimal,” Smith explained. “Kids who are fighting these conditions can be treated with anti-inflammatory products such as NSAIDs, low-dose steroids or, if they need them, immune-suppressing medications. Many of these are pills that have very low risks of side-effects,” he added.
Smith says once a child begins the treatment process, parents will notice improvements. “Kids usually will become more active, be happier, socialize more normally, sleep without pain and grow normally,” he said. “When treatments first start, though, it’s important to remember that there will be fairly frequent doctor visits as we try to get the child’s disease under control. However, once the child begins to improve, we will space out those appointments more and allow him or her to return to normal activities as much as possible. At that point, we can see the child at the clinic a few times a year, which should make things relatively normal for the child and his or her family,” he explained.
Dr. Smith sees patients in his office at East Tennessee Medical Group, located at 266 Joule St. in Alcoa, and is the only pediatric rheumatologist currently serving Blount County.