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Pediatric vs Adult Rheumatology

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Juvenile Idiopathic Arthritis (JIA)

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Pediatric: Often presents with a limp, growth problems; Adults: More likely to present with joint stiffness and swelling. Treatment may include growth monitoring in children.

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Scleroderma

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Pediatric: More likely to present with localized skin conditions; Adults: Often systemic with complications such as pulmonary hypertension. Regular screening for organ involvement is important in adults.

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Lyme Disease

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Pediatric: Often presents with erythema migrans rash and mild flu-like symptoms; Adults: Also presents with rash but may have more pronounced arthritis and neurological symptoms. Antibiotics are the main treatment for both.

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Fibromyalgia

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Pediatric: May present with diffuse pain and be mistaken for growing pains; Adults: Features chronic widespread pain and fatigue. A multidisciplinary approach including cognitive behavioral therapy is often used in both.

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Psoriatic Arthritis

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Pediatric: Can occur in teens with psoriasis, may present with sausage-like finger swelling; Adults: More often seen with nail changes and joint issues. Treatment with biologics might be considered in both.

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Slipped Capital Femoral Epiphysis (SCFE)

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Pediatric: More common in obese adolescents, presents with hip pain and altered gait; Adults: Not applicable, it is a pediatric condition. Treatment often involves surgical pinning in children.

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Dermatomyositis

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Pediatric: Rash may be more pronounced, calcinosis more common; Adults: Symmetrical muscle weakness is a key feature. Both may require biopsy for diagnosis.

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Gout

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Pediatric: Extremely rare in children, if present often related to genetic disorders; Adults: More common, presents with acute joint pain and urate crystals in joints. Management includes dietary modification and medication like allopurinol in both.

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Ankylosing Spondylitis

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Pediatric: Rare and may present with less severe symptoms; Adults: More common, with hallmark chronic lower back pain and stiffness. Both may involve HLA-B27 testing.

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Osteoporosis

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Pediatric: Rare, usually secondary to other conditions; Adults: Common, especially in postmenopausal women. In children, focus on underlying cause. In adults, calcium and vitamin D supplementation is key.

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Kawasaki Disease

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Pediatric: Typically under 5 years, presents with high fever, rash, lymphadenopathy; Adults: Rare, but may present with cardiovascular complications. Treatment focused on preventing coronary artery aneurysms in children.

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Reactive Arthritis

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Pediatric: May follow gastrointestinal or genitourinary infections, can present with conjunctivitis and urethritis; Adults: Similar triggers, but with more prominent spondyloarthropathy features. Treatment focuses on the underlying infection and symptom management.

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Osteogenesis Imperfecta

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Pediatric: Presents with frequent fractures, blue sclera, and growth issues; Adults: Focus on management of chronic pain and maintaining mobility. Genetic counseling is important in both.

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Growing Pains

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Pediatric: Common in young children, often occurring in legs; Adults: Not applicable, as it's specific to pediatric growth periods. Reassurance and symptom management are key in pediatrics.

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Henoch-Schonlein Purpura (HSP)

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Pediatric: Most common in children, presents with palpable purpura, abdominal pain; Adults: Less common, but may have more severe renal involvement when it does occur.

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Marfan Syndrome

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Pediatric: Early presentation with joint hypermobility, eye problems, and cardiac issues; Adults: Continuation of childhood symptoms, with increased risk of aortic dissection. Genetic counseling and echocardiograms are routine.

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Systemic Lupus Erythematosus (SLE)

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Pediatric: Can present with more severe organ involvement; Adults: Typically presents with more musculoskeletal and dermal symptoms. Both require monitoring for kidney involvement.

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Rheumatic Fever

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Pediatric: Follows Group A Streptococcal infection, can lead to rheumatic heart disease; Adults: Rare, and usually only in those with recurrent childhood cases. Use of antibiotics for prophylaxis is key in children.

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Pain Amplification Syndrome

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Pediatric: Also known as amplified musculoskeletal pain, presents with intense pain disproportionate to physical findings; Adults: May manifest as chronic pain syndromes like fibromyalgia. Multidisciplinary approach including physical therapy is common in both.

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