Multi-System Disease

Many acute and chronic conditions involve joint, muscle or bone pain. There can be arthritis (with swelling and pain affecting one of more joints) or arthralgia (painful joints without overt swelling) with or without myalgia (muscle pain) or myositis (muscle pain and tenderness, often with weakness). 

This section gives more information about Multi-System disease (including infections, autoimmune rheumatic diseases, autoinflammatory diseases and genetic conditions).

Many rheumatic and musculoskeletal diseases form a continuum between classical autoimmune and autoinflammatory conditions.

Making a diagnosis rests on meticulous clinical assessment with careful use and interpretation of investigations.  Guidance to the approach for a child with prolonged fever is available. 

Many rheumatic diseases in children affect multiple organs as they often involve the joints, muscles and connective tissues; however they can sometimes present with symptoms predominantly affecting a single organ system e.g., the kidneys, gastrointestinal tract, lungs and eyes. A child with SLE may present with just nephrotic syndrome or a child with JIA may present with uveitis as the initial presentation. Pulmonary haemorrhage may be the first sign of an ANCA vasculitis. 

More information about the approach to suspected multi-system rheumatic disease is available. 

We include cases to highlight approaches to the differential diagnosis. 

The photograph below shows skin vasculitis - more information about skin manifestations is available