If a child has JIA that does not get better with other drugs, and if only a few joints are affected, their doctor may suggest that they have corticosteroid joint injections. The corticosteroid is injected directly into the joints that are inflamed. This is also called an intra-articular injection.
Why are corticosteroid joint injections used?
Joint injections are helpful because the corticosteroid can be placed right into the inflamed joint. Because the medicine is put right where it needs to be, it does not travel through the rest of the body. Therefore, it does not cause the same side effects that are seen with corticosteroids taken by mouth or IV.
The benefits of joint injections are:
- They have a low risk of side effects.
- They work quickly to control active inflammation in a joint.
- The initial improvement in your symptoms is often dramatic. It occurs within days to a week following the joint injection.
- Your joints may stay better for months or even longer.
How are joint injections done?
The rheumatologist will carefully inject the corticosteroid medication into the joint. This procedure can be done in a variety of ways, depending on your child's needs and what the doctor thinks.
Joint injectionSometimes the joint injection may be done in the clinic or in a special procedure room. Sometimes it is done in an X-ray or ultrasound room. The X-ray or ultrasound is used to make sure the joint is injected correctly.
The doctor may use a pain medication, called a local anaesthetic, to numb the skin before the injection. Your child might need a medicine called a sedative to help them relax for the joint injection procedure. If many joints need to be injected at one time, this may be done while your child is asleep under general anaesthesia.
To learn more about joint injections, check out the following animation.
Which corticosteroids are injected into joints?
There are three corticosteroids that are used for joint injections:
Triamcinolone hexacetonide
Most common brand name: Lederlon
How it is given: Joint injection 1 to 3 times per year as needed
How the medication comes: Injection
Possible side effects
- Risk of infection in joint (unusual if proper cleaning of skin and sterile techniques utilized)
- Thinning of skin over joint injection site
- Steroids injected into joints can sometimes be seen as deposits on X-rays (does not cause symptoms of pain or affect function of joint)
Triamcinolone acetonide
Most common brand name: Kenalog
How it is given: Joint injection 1 to 3 times per year as needed
How the medication comes: Injection
Possible side effects
- Risk of infection in joint (unusual if proper cleaning of skin and sterile techniques utilized)
- Thinning of skin over joint injection site
- Steroids injected into joints can sometimes be seen as deposits on X-rays (does not cause symptoms of pain or affect function of joint)
Methyl-prednisolone
Most common brand name: Depo-Medrol
How it is given: Joint injection 1–3 times per year as needed
How the medication comes: Injection
Possible side effects
- Risk of infection in joint (unusual if proper cleaning of skin and sterile techniques utilized)
- Thinning of skin over joint injection site
- Steroids injected into joints can sometimes be seen as deposits on X-rays (does not cause symptoms of pain or affect function of joint)
Important safety point about corticosteroid joint injection(s)
If, within 24 to 48 hours following a joint injection, your child develops fever, redness, or increasing pain over the joint injection site, take your child to the doctor immediately to ensure there is no infection in the joint.
