Interpretation of results of specific laboratory tests (including but not limited to): sedimentation rate; C-reactive protein and other acute phase reactants; iron studies, including ferritin; rheumatoid factor; antinuclear antibodies; anti-ds-DNA; anti-SS-A/Ro; anti-SS-B/La; anti-U1-RNP; anti-Sm; anti-ribosomal P; anticentromere; antitopoisomerase 1; anti-JO-1, anti-PM-ScL; antineutrophil cytoplasmic antibodies; cryoglobulins; complement component levels; CH50; serum protein electrophoresis; serum immunoglobulin levels; LE cell preparation; RPR; lupus anticoagulant; anticardiolipin antibodies; HLA typing (e.g., HLA B27); antihistone antibodies; ASO and other streptococcal antibody tests; Lyme serologies; circulating immune complexes; lymphocyte subset and function data and anticellular antibodies (e.g., Coombs, neutrophils, platelets)
Plain radiographs
Joint ultrasound including ultrasound guided joint aspiration and injection
Interpretation of results from the following tests:
Diagnostic imaging techniques
Radionuclide scanning techniques
Arteriograms in the vasculitidies
Electromyograms and nerve conduction studies
Biopsy specimens including histochemistry and immunofluorescence of tissues
Others: nailfold capillary examination, ischemic forearm muscle test, Schirmer's and rose bengal tests, closed needle synovial biopsy and arthroscopy
Demonstrate the ability to construct a differential diagnosis in children presenting with signs and symptoms related to rheumatologic diseases and to outline further testing necessary to establish the correct diagnosis
Using the basic principles of decision analysis, understand the indications for and costs of ordering laboratory tests and procedures to establish a diagnosis of a rheumatologic disease
Understand indications for surgical and orthopaedic consultation in acute and chronic rheumatic diseases
For each procedure, the fellow should possess a working knowledge of indications, preoperative evaluation and medication adjustments, contraindications, complications, postoperative management and expected outcome:
Arthroscopy
Synovectomy of tendons and joints
Spine surgery: radiculopathy, stenosis and instability
Reconstructive surgery of hand and foot
Total joint replacement: hip, knee, shoulder, other
Infected joint
Infected joint management principles
Infected prosthetic joint
Non-allopathic medical practices: diet, nutritional supplements, antimicrobials, acupuncture, topicals, homeopathic remedies, venoms and others
Using the basic principles of decision analysis, understand the indications for and cost of different therapies used in the management of pediatric rheumatic diseases
