Ultrasound-guided Corticosteroid Injection of the Subtalar Joint for Treatment of Juvenile Idiopathic Arthritis

Overview

Journal Pediatr Radiol

Specialty Pediatrics

Date 2015 Feb 13

PMID 25672519

Citations 4

Authors

Cody M Young

Deanna M Horst

James W Murakami

William E Shiels 2nd

Affiliations

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Abstract

Background: The subtalar joint is commonly affected in children with juvenile idiopathic arthritis and is challenging to treat percutaneously.

Objective: To describe the technique for treating the subtalar joint with US-guided corticosteroid injections in children and young adults with juvenile idiopathic arthritis and to evaluate the safety of the treatment.

Materials And Methods: We retrospectively analyzed 122 patients (age 15 months-29 years) with juvenile idiopathic arthritis who were referred by a pediatric rheumatologist for corticosteroid injection therapy for symptoms related to the hindfoot or ankle. In these patients the diseased subtalar joint was targeted for therapy, often in conjunction with adjacent affected joints or tendon sheaths of the ankle. We used a protocol based on age, weight and joint for triamcinolone hexacetonide or triamcinolone acetonide dose prescription. We describe the technique for successful treatment of the subtalar joint.

Results: A total of 241 subtalar joint corticosteroid injections were performed under US guidance, including 68 repeat injections for recurrent symptoms in 26 of the 122 children and young adults. The average time interval between repeat injections was 24.8 months (range 2.2-130.7 months, median 14.2 months). Subcutaneous tissue atrophy and skin hypopigmentation were the primary complications observed. These complications occurred in 3.9% of the injections.

Conclusion: With appropriate training and practice, the subtalar joint can be reliably and safely targeted with US-guided corticosteroid injection to treat symptoms related to juvenile idiopathic arthritis.

Citing Articles

Contribution of Ultrasound in Current Practice for Managing Juvenile Idiopathic Arthritis.

Borocco C, Anselmi F, Rossi-Semerano L J Clin Med. 2023; 12(1).

PMID: 36614888 PMC: 9821589. DOI: 10.3390/jcm12010091.

Musculoskeletal ultrasound in children: Current state and future directions.

Brunner E, Ting T, Vega-Fernandez P Eur J Rheumatol. 2022; 7(Suppl1):S28-S37.

PMID: 35929859 PMC: 7004269. DOI: 10.5152/eurjrheum.2019.19170.

Application of Intra-articular Corticosteroid Injection in Juvenile Idiopathic Arthritis.

Li S, Zhang W, Lin Y Front Pediatr. 2022; 10:822009.

PMID: 35425732 PMC: 9002113. DOI: 10.3389/fped.2022.822009.

Current status and recent advances on the use of ultrasonography in pediatric rheumatic diseases.

Zou L, Lu M, Leung Jung L World J Pediatr. 2019; 16(1):52-59.

PMID: 31515696 DOI: 10.1007/s12519-019-00312-9.

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