Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Dec;42(12):1481-9.
doi: 10.1007/s00247-012-2487-y. Epub 2012 Sep 2.

Ultrasound-guided corticosteroid injection therapy for juvenile idiopathic arthritis: 12-year care experience

Cody M Young  1 , William E Shiels 2nd, Brian D Coley, Mark J Hogan, James W Murakami, Karla Jones, Gloria C Higgins, Robert M Rennebohm
Affiliations

Ultrasound-guided corticosteroid injection therapy for juvenile idiopathic arthritis: 12-year care experience

Cody M Young et al. Pediatr Radiol. 2012 Dec.

Abstract

Background: Intra-articular corticosteroid injections are a safe and effective treatment for patients with juvenile idiopathic arthritis. The potential scope of care in ultrasound-guided corticosteroid therapy in children and a joint-based corticosteroid dose protocol designed to optimize interdisciplinary care are not found in the current literature.

Objective: The purpose of this study was to report the spectrum of care, technique and safety of ultrasound-guided corticosteroid injection therapy in patients with juvenile idiopathic arthritis and to propose an age-weight-joint-based corticosteroid dose protocol.

Materials and methods: A retrospective analysis was performed of 198 patients (ages 21 months to 28 years) referred for treatment of juvenile idiopathic arthritis with corticosteroid therapy. Symptomatic joints and tendon sheaths were treated as prescribed by the referring rheumatologist. An age-weight-joint-based dose protocol was developed and utilized for corticosteroid dose prescription.

Results: A total of 1,444 corticosteroid injections (1,340 joints, 104 tendon sheaths) were performed under US guidance. Injection sites included small, medium and large appendicular skeletal joints (upper extremity 497, lower extremity 837) and six temporomandibular joints. For patients with recurrent symptoms, 414 repeat injections were performed, with an average time interval of 17.7 months (range, 0.5-101.5 months) between injections. Complications occurred in 2.6% of injections and included subcutaneous tissue atrophy, skin hypopigmentation, erythema and pruritis.

Conclusion: US-guided corticosteroid injection therapy provides dynamic, precise and safe treatment of a broad spectrum of joints and tendon sheaths throughout the entire pediatric musculoskeletal system. An age-weight-joint-based corticosteroid dose protocol is effective and integral to interdisciplinary care of patients with juvenile idiopathic arthritis.

PubMed Disclaimer

References

    1. Rheumatology (Oxford). 2003 Aug;42(8):976-9 - PubMed
    1. Ann Rheum Dis. 1997 Jan;56(1):59-63 - PubMed
    1. J Ultrasound Med. 2009 Jun;28(6):737-43 - PubMed
    1. Rheumatology (Oxford). 2008 Dec;47(12):1792-4 - PubMed
    1. Rheumatology (Oxford). 2004 Oct;43(10):1288-91 - PubMed

MeSH terms

Substances

LinkOut - more resources