Intra-articular glucocorticoids in early juvenile chronic arthritis

The efficacy of intra-articular glucocorticoid injections in the early phase of knee joint synovitis was studied in 79 children with juvenile chronic arthritis (42 girls and 37 boys). Half of the injections were given within the first six months from the onset of the disease. The probability of a patient staying in remission was much higher in triamcinolone-treated patients than in patients receiving methylprednisolone (p < 0.0005, Breslow statistics). Using multivariate analysis there was a significant association between the length of remission and the synovial fluid polymorphonuclear leucocyte proportion (SF-PMN%). Patients with a high SF-PMN% tended to have shorter remissions than those with a low SF-PMN% (improvement of the fit in stepwise model: chi-square = 8.81, p < 0.005). The difference between triamcinolone and methylprednisolone groups was still clearly evident two years after injection.