Rheumatology

The IWK Rheumatology Service helps by providing clinical care for children and youth living in the Maritime Provinces who have a suspected or definite diagnosis of a childhood rheumatic disease. 

How we help

We provide high-quality care to children and youth who have a condition such as:

• Juvenile Arthritis (one of the most common chronic illnesses affecting children)
• Systemic Lupus Erythematosus
• Juvenile dermatomyositis
• Other connective tissue diseases
• Various forms of systemic vasculitis that can cause inflammation and injury to organs of the body.

We’re also frequently involved in the assessment of children and adolescents with muscle and joint problems of unknown cause, or those associated with another medical condition, for example, hemophilia. Both in-patient and out-patient care is provided. Children who require hospitalization will stay in the Pediatric Medical Unit (PMU).

New patients are accepted into clinic before their 16th birthday when we receive a doctor’s referral. A referral for the Rheumatology Clinic should be faxed or mailed to the Rheumatology office at IWK Health. How long you wait for an appointment will depend on why your child is being referred and how sick your child is compared to other children waiting for appointments. If you're worried that your child is getting sicker while waiting for an appointment, you should have them seen by his or her regular doctor who can update the referral information by communicating his or her concerns to our clinic. Urgent referrals should be communicated directly between the referring doctor and the rheumatologist on call, via the IWK switchboard or the Rheumatology administrative office. 

In addition to regular clinics at the IWK, the rheumatologists travel to Fredericton and Saint John, New Brunswick, and Charlottetown, PEI, several times per year to provide follow-up appointments for many patients. The team is also dedicated to research, teaching and advocacy.

What to expect

You'll be notified of your child’s appointment by mail and/or phone call. The clinic is located in Medical Day Unit on the second floor of IWK Health Centre, Children’s Building. The first visit to the clinic may last two to three hours or longer. We encourage you to bring the following items with you:

• Your child’s health card, insurance information, and contact information of your family physician 
• Your appointment letter
• All of your child’s medications in their original labeled containers
• A pair of shorts for your child to wear during the examination
• A list of questions you and your child may have for the physician. Some questions may include those related to activity level, pain management, and return to school or sports. Also, remember to ask for any instructions from the doctor or letters of medical necessity that you may need for school or your child's family physicians/pediatrician.
• Lunch/snacks, books, toys, or activities for your child 

Follow-up care, if required, will be reviewed prior to your leaving clinic. The booking clerk will notify you of follow-up appointments by mail and/or a phone call. Bilingual and Child Life services may be available as requested. If possible, please let us know in advance by contacting the booking clerk so arrangements can be made prior to the appointment day. 

Who you’ll meet

The Rheumatology team is an interdisciplinary team consisting of four pediatric rheumatologists and registered nurses in clinic and the Medical Day Unit, as well as physiotherapy, occupational therapy, social work, pharmacy, research coordinators, and a booking clerk.

Pediatric Rheumatologists 
The pediatric rheumatologists are pediatricians who diagnose and treat joint, muscle, and bone disorders in children and youth, having special knowledge and training in managing diseases of inflammation.

 

Registered Nurses
The registered nurses in the Rheumatology Clinic have a high level of knowledge, skill, and competence in the area of pediatric rheumatology. The nurse is responsible for coordinating patient care, as well as teaching, relating to disease, medications, and healthy lifestyle issues. The nurse is available to provide telephone support to patients and families between clinic visits when needed.

 

Physiotherapist 
The physiotherapist in the rheumatology service provides a detailed assessment when needed and designs a suitable exercise program for your child that assists in maintaining and improving joint movement, muscle strength, and active living. At follow-up visits, the physiotherapist may modify the exercise program to meet your child’s needs and better manage the arthritis.

 

Occupational Therapist 
The occupational therapist in the rheumatology team helps your child with the demands of daily living, school, and play. The occupational therapist can show your child how to perform ordinary tasks and activities and help minimize pain and discomfort. This may include suggesting devices (such as modified pencils and splints) to make things more comfortable for your child. Addressing sleep can help your child deal with problems like fatigue and pain.

Social Worker
The social worker is involved in the emotional or practical problems related to your child’s condition, such as coping and adjustment, behaviour, family therapy, and support groups for families. This may include advocacy and helping to meet the challenges, including financial, of living with a chronic condition.

 

Pharmacist

The pharmacist can help with issues related to medication including education about medication actions, side effects and interactions with other medications, assisting with getting access or coverage for medications, interacting with your local pharmacy and helping to troubleshoot issues related to giving medications. 

 

Research Coordinator
The research coordinator organizes research activities and helps families who are involved in research study visits. Patients who meet criteria will be invited to voluntarily participate in research projects in an effort to allow us to learn more about many areas affecting children and youth with rheumatic diseases.

 

Booking Clerk
The booking clerk will schedule your child’s appointment with the rheumatologist and other team members. With advance notice, every effort will be made to coordinate the visit with your child’s other appointments.

 

Administrative Staff
The administrative staff performs duties including clerical and administrative activities that support the academic mission of the Division of Pediatric Rheumatology.