Rheumatic diseases in adolescence

OBJECTIVE: To present an updated review concerning the most prevalent diseases with musculoskeletal signs and symptoms that make adolescents seek medical care, giving special emphasis to rheumatic diseases. Our aim is to offer physicians and health care providers the possibility of distinct differential diagnoses, thus allowing them to establish a therapeutic approach and, if necessary, refer the patient to a specialist METHODS: Review of literature using Medline database, data obtained at our department, and the author? personal experience. RESULTS: Musculoskeletal pain is characteristic of several diseases and usually urges adolescents to seek medical care. Rheumatic diseases, especially rheumatic fever, account for nearly fifty percent of the cases. In adolescents, it is also important that the aspects regarding the diagnosis and treatment of idiopathic juvenile arthritis, arthritis associated with enthesitis, systemic lupus erythematosus, and vasculitis be considered. Fibromyalgia, reflex sympathetic dystrophy, growing pains, hypermobility syndrome, and psychogenic rheumatism are noninflammatory conditions that frequently mimic rheumatic diseases. CONCLUSIONS: Inflammatory and noninflammatory conditions, and diseases of different etiology (infectious, neoplastic, and orthopedic) are frequently associated with musculoskeletal pain. It is important that health professionals diagnose these diseases as early as possible so that prompt action can be taken and prognosis can be improved.