Bringing much-needed paediatric
rheumatology care closer to home
When eight-year-old Catalina Bursey began complaining of pain in her knees, her parents attributed it to an injury she may have received during one of cheerleading competitions.
But when Catalina woke up one morning with pain so unbearable that she couldn’t walk, her parents Graham and Gail Bursey knew that it was more than a sports injury. “At that point, we knew that something was very wrong,” remembers Graham, Catalina’s father.
They immediately brought her to Rouge Valley Ajax and Pickering’s emergency department. Their emergency physician referred the Burseys to a paediatrician at the hospital who suspected that Catalina may have juvenile arthritis. She was then referred to the hospital’s new paediatric rheumatology clinic, located at Rouge Valley Centenary’s (RVC) east Toronto hospital campus.
“We were grateful that it didn’t take long for us to get into the clinic, and get an appointment,” explains Gail, Catalina’s mother, who was the clinic’s very first patient.
Thanks to Rouge Valley’s new clinic, kids like Catalina are able to get much needed paediatric rheumatology care closer to home.
Led by paediatric rheumatologist Dr. Karoon Danayan, the clinic, which opened in January, is based at RVC’s Galaxy 12 paediatric clinic. So far, it already sees approximately 40 patients each month. Of each of those patients seen, about one-third require treatment for a rheumatic issue. Some of those diseases include juvenile idiopathic arthritis, lupus, juvenile dermatomyositis, and scleroderma.
Dr. Danayan is one of just four paediatric rheumatologists working in the Greater Toronto Area (GTA). Her clinic sees patients coming from across east Toronto straight to the west Durham Region.
During her paediatric rheumatology fellowship at the Hospital for Sick Children, Dr. Danayan saw that many of the patients were coming in all the way from east Toronto and west Durham Region. She soon learned that paediatric rheumatology patients in that area of the GTA were in need of this care closer to home.
“I started this clinic because there are no other paediatric rheumatologists in this area. I chose Rouge Valley because the Galaxy 12 clinic is an established paediatric subspecialty clinic,” she explains. Since rheumatic diseases often affect more than one area of the body, she adds that working in a clinic with access to more than one paediatric specialist is an advantage for patients.
Rheumatic diseases can cause pain and swelling of the joints, rashes, and fever, among other symptoms. While most can be treated or managed with medication, if they go undiagnosed, they can lead to joint or organ damage.
One challenge for paediatric patients, Dr. Danayan explains, is that rheumatic diseases are also harder to diagnose in children because it often affects younger children who can’t always articulate their symptoms.
“Often our patients present with chronic diseases that, for months, have been unrecognizable. Many people don’t think that kids can get rheumatic diseases like arthritis, so it often goes missed,” explains Dr. Danayan. “Children with arthritis often push through the pain and don’t complain. They remain active and they cope with the pain. This can make it harder to recognize that there is a problem.”
Through their close relationship with the Hospital for Sick Children, if a patient needs access to more advanced care and specialists, they can be transferred there. Referrals to the clinic are made through the patient’s physician. They are usually seen fairly quickly, with patients presenting with more severe symptoms being seen even quicker.
One of Dr. Danayan’s top priorities is to help gain more awareness about paediatric rheumatology, both in the public and within the medical community. But above all, she hopes to help provide relief and better education to her patients and their families.
“Some of the patients I have seen had unrecognized disease for months and sometimes years. It’s very satisfying when you’re able to finally make a diagnosis and help the patient,” she explains.