Truckenbrodt H
Rheumakinderklinik Garmisch-Partenkirchen.
Z Rheumatol. 1990 Sep-Oct;49(5):260-7.
Pediatric rheumatology represents a specialized subject which overlaps with important fields of pediatrics, as well as with adult rheumatology. As a speciality it includes age-specific rheumatologic diseases, an age-dependent differential diagnosis, special growth disturbances and joint deformities that are also influenced by age, and a subgroup of juvenile chronic arthritis. Socio-medical problems arise from a child's impaired physical and psychosocial development and their impact on education, the individual's choice of career, and effects on the patient's family. For pediatricians who are trained in this field and who treat only or predominantly children with rheumatic diseases the subspeciality of pediatric rheumatology should be introduced. In the future, precise figures on incidence and prevalence of juvenile rheumatic diseases in Germany must be obtained. Therapy of children with chronic arthritis affords improvement and further development by comprehensive training and further education of physicians and physiotherapists. Thus, it is important to take advantage of possibilities of inpatient and outpatient care, as well as the co-ordination of existing institutions. Arthralgias and acute rheumatic disorders in children present in a relatively high frequency. Chronic arthritis, however, is rare and treatment requires a supra-regional center for pediatric rheumatology. Quality of therapy for children with chronic rheumatic diseases must be considered prior to a locally oriented care. More intensive research is needed, with more clinical studies and basic research. More effort must be made to integrate analyse of musculoskeletal function and the importance of joint-deformity development into the research program. Further cooperation between pediatric rheumatology centers and universities would offer significant advantages in the future.
小儿风湿病是一门与儿科学的重要领域以及成人风湿病学都有交叉的专业学科。作为一门专科，它涵盖了特定年龄段的风湿性疾病、与年龄相关的鉴别诊断、特殊的生长发育障碍以及同样受年龄影响的关节畸形，还有青少年慢性关节炎的一个亚组。社会医学问题源于儿童身体和心理社会发育受损及其对教育、个人职业选择以及对患者家庭的影响。对于在该领域接受过培训且仅治疗或主要治疗风湿性疾病患儿的儿科医生而言，应引入小儿风湿病亚专科。未来，必须获取德国青少年风湿性疾病发病率和患病率的精确数据。通过对医生和物理治疗师进行全面培训和继续教育，慢性关节炎患儿的治疗得到了改善和进一步发展。因此，利用住院和门诊护理的可能性以及协调现有机构非常重要。儿童关节痛和急性风湿性疾病的发病率相对较高。然而，慢性关节炎较为罕见，治疗需要一个跨地区的小儿风湿病中心。在进行以地区为导向的护理之前，必须考虑慢性风湿性疾病患儿的治疗质量。需要开展更深入的研究，包括更多的临床研究和基础研究。必须更加努力地将肌肉骨骼功能分析以及关节畸形发展的重要性纳入研究计划。未来，小儿风湿病中心与大学之间的进一步合作将带来显著优势。
