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

Cody M Young1, William E Shiels, Brian D Coley

  • 1Department of Radiology and The Children's Radiological Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. cody.young@nationwidechildrens.org

Pediatric Radiology
|September 4, 2012
PubMed

Insights

Ultrasound-guided corticosteroid injections offer precise and safe treatment for juvenile idiopathic arthritis. An age-weight-joint-based protocol enhances care for children with this condition.

Area of Science:

  • Pediatric Rheumatology
  • Musculoskeletal Imaging
  • Interventional Pain Management

Background:

  • Intra-articular corticosteroid injections are established treatments for juvenile idiopathic arthritis (JIA).
  • Current literature lacks comprehensive data on the scope of ultrasound-guided corticosteroid therapy in pediatric patients.
  • A standardized, joint-based corticosteroid dosing protocol for JIA is needed to optimize interdisciplinary care.

Purpose of the Study:

  • To detail the spectrum of care, technique, and safety of ultrasound-guided corticosteroid injections in JIA patients.
  • To introduce and evaluate an age-weight-joint-based corticosteroid dosing protocol for JIA.

Main Methods:

  • Retrospective analysis of 198 JIA patients (21 months to 28 years).
  • Ultrasound-guided corticosteroid injections administered to symptomatic joints and tendon sheaths.
  • Development and application of an age-weight-joint-based corticosteroid dose protocol.

Main Results:

  • 1,444 ultrasound-guided injections performed (1,340 joints, 104 tendon sheaths).
  • Injections covered a wide range of appendicular joints and temporomandibular joints.
  • Complications occurred in 2.6% of injections, including localized tissue reactions.

Conclusions:

  • Ultrasound-guided corticosteroid injections provide dynamic, precise, and safe treatment across the pediatric musculoskeletal system.
  • The developed age-weight-joint-based protocol is effective and crucial for integrated JIA patient care.
Abstract

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