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

Young, Cody; Shiels, William E.; Coley, Brian D.; Hogan, Mark; Murakami, James W.; Jones, Karla; Higgins, Gloria C.; Rennebohm, Robert M.

doi:10.1007/s00247-012-2487-y

Cited by 54 publications

(26 citation statements)

References 29 publications

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“…Young et al [13] reported that 75% of the 104 tendon sheath injections were performed in the foot/ankle region in their cohort of patients with JIA. Javadi et al [6] studied 45 patients with a confirmed diagnosis of JIA and determined using MRI that tenosynovitis was present in 59% of wrists and in 33% of ankles with synovitis respectively, with the tibialis posterior being the most commonly involved.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

et al. 2017

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BackgroundThe aims of this study were to: (a) Identify tendon sheaths most commonly treated with steroid injections in a pediatric patient population with Juvenile Idiopathic Arthritis (JIA); (b) Describe technical aspects of the procedure; (c) Characterize sonographic appearance of tenosynovitis in JIA; (d) Assess agreement between clinical request and sites injected.MethodsThis was a 10 year single-center retrospective study (May 2006-April 2016) of patients with JIA referred by Rheumatology for ultrasound-guided tendon sheath injections. Patient demographics, clinical referral information, sonographic appearance of the tendon sheaths and technical aspects of the procedure were analyzed.ResultsThere were 308 procedures of 244 patients (75% female, mean age 9.6 years) who underwent a total of 926 tendon sheath injections. Ankle tendons were most commonly injected (84.9%), specifically the tendon sheaths of tibialis posterior (22.3%), peroneus longus (20%) and brevis (19.7%). The majority of treated sites (91.9%) showed peritendinous fluid and sheath thickening on ultrasound. There were 2 minor intra-procedure complications without sequelae. A good agreement between clinical request and sites injected was observed.ConclusionsUltrasound-guided tendon sheath injections with steroids are used frequently to treat patients with JIA. It is a safe intervention with a high technical success rate. The ankle region, specifically the medial compartment, is the site most commonly injected in this group of patients. The most common sonographic finding is peritendinous fluid and sheath thickening. These findings might assist clinicians and radiologists to characterize and more effectively manage tenosynovitis in patients with JIA.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

et al. 2017

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“…All studies used triamcinolone injections; doses and preparations varied according to the age of the patient and the joint being injected. Young et al 59 used US to assess the accuracy of needle placement for steroid injections at various sites (joints and tendon sheaths), and described that US allowed accurate visualisation of the injection point in all 1444 injections. A study by Parra et al 60 used CT to establish if US-guided TMJ injections had been accurately placed; needle placement was shown to be acceptable in 91% (75% required no needle adjustment, 16% required minor adjustment) and unacceptable in 9% where the needle required major readjustment.…”

Section: Resultsmentioning

confidence: 99%

EULAR-PReS points to consider for the use of imaging in the diagnosis and management of juvenile idiopathic arthritis in clinical practice

et al. 2015

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To develop evidence based points to consider the use of imaging in the diagnosis and management of juvenile idiopathic arthritis ( JIA) in clinical practice. The task force comprised a group of paediatric rheumatologists, rheumatologists experienced in imaging, radiologists, methodologists and patients from nine countries. Eleven questions on imaging in JIA were generated using a process of discussion and consensus. Research evidence was searched systematically for each question using MEDLINE, EMBASE and Cochrane CENTRAL. Imaging modalities included were conventional radiography, ultrasound, MRI, CT, scintigraphy and positron emission tomography. The experts used the evidence obtained from the relevant studies to develop a set of points to consider. The level of agreement with each point to consider was assessed using a numerical rating scale. A total of 13 277 references were identified from the search process, from which 204 studies were included in the systematic review. Nine points to consider were produced, taking into account the heterogeneity of JIA, the lack of normative data and consequent difficulty identifying pathology. These encompassed the role of imaging in making a diagnosis of JIA, detecting and monitoring inflammation and damage, predicting outcome and response to treatment, use of guided therapies, progression and remission. Level of agreement for each proposition varied according to the research evidence and expert opinion. Nine points to consider and a related research agenda for the role of imaging in the management of JIA were developed using published evidence and expert opinion.

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“…Only 1 study specifically addresses JSpA 184 . Most data are extra polated from studies of JIA (LOE I, SOR B) 185,186,187,188,189,190 .…”

Section: Corticosteroidsmentioning

confidence: 97%

2014 Update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada Treatment Recommendations for the Management of Spondyloarthritis. Part II: Specific Management Recommendations

Rohekar

Chan²,

Tse³

et al. 2015

J Rheumatol

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

Cited by 54 publications

References 29 publications

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

EULAR-PReS points to consider for the use of imaging in the diagnosis and management of juvenile idiopathic arthritis in clinical practice

2014 Update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada Treatment Recommendations for the Management of Spondyloarthritis. Part II: Specific Management Recommendations

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