Document Detail


A reappraisal of intra-articular corticosteroid therapy in juvenile idiopathic arthritis.
MedLine Citation:
PMID:  20863449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intraarticular corticosteroid (IAC) injection is a safe and rapidly effective treatment for synovitis in children with juvenile idiopathic arthritis (JIA). This procedure can be performed in an ambulatory care setting using local anaesthesia, with or without conscious sedation. Younger children, or those candidate to multiple injections, require general anaesthesia. Triamcinolone hexacetonide is the optimal corticosteroid preparation. However, for smaller joints or joints that are not easy to assess clinically, use of a more soluble corticosteroid drug is advised. Imaging guidance may facilitate accurate placement of the needle within the joint space. Use of ultrasound for this purpose has gained increasing popularity in the recent years. IAC injections are used most frequently to treat oligoarthritis, but the strategy of performing multiple IAC injections to induce disease remission, while simultaneously initiating therapy with second-line or biologic agents, has been proposed also for children with polyarticular JIA. However, the current place of IAC therapy in the management of children with JIA is uncertain due to the lack of controlled studies. Furthermore, it is still unknown whether this therapy has a disease-modifying effect over the long-term. This review summarises the present information about the use of IAC therapy in children with JIA.
Authors:
C Scott; S Meiorin; G Filocamo; S Lanni; M Valle; C Martinoli; A Martini; A Ravelli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-10-22
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  28     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  774-81     Citation Subset:  IM    
Affiliation:
Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, Genova, Italy, and 2School of Adolescent and Child Health, University of Cape Town, South Africa. christiaanscott@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antirheumatic Agents / administration & dosage*
Arthritis, Juvenile Rheumatoid / drug therapy*
Child
Child, Preschool
Female
Glucocorticoids / administration & dosage*
Humans
Injections, Intra-Articular
Male
Ultrasonography, Interventional / methods
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 0/Glucocorticoids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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