Abstract | BACKGROUND: OBJECTIVE: MATERIALS AND METHODS: A retrospective analysis was performed of 198 patients (ages 21 months to 28 years) referred for treatment of juvenile idiopathic arthritis with corticosteroid therapy. Symptomatic joints and tendon sheaths were treated as prescribed by the referring rheumatologist. An age-weight-joint-based dose protocol was developed and utilized for corticosteroid dose prescription. RESULTS: A total of 1,444 corticosteroid injections (1,340 joints, 104 tendon sheaths) were performed under US guidance. Injection sites included small, medium and large appendicular skeletal joints (upper extremity 497, lower extremity 837) and six temporomandibular joints. For patients with recurrent symptoms, 414 repeat injections were performed, with an average time interval of 17.7 months (range, 0.5-101.5 months) between injections. Complications occurred in 2.6% of injections and included subcutaneous tissue atrophy, skin hypopigmentation, erythema and pruritis. CONCLUSION: US-guided corticosteroid injection therapy provides dynamic, precise and safe treatment of a broad spectrum of joints and tendon sheaths throughout the entire pediatric musculoskeletal system. An age-weight-joint-based corticosteroid dose protocol is effective and integral to interdisciplinary care of patients with juvenile idiopathic arthritis.
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Authors | Cody M Young, William E Shiels 2nd, Brian D Coley, Mark J Hogan, James W Murakami, Karla Jones, Gloria C Higgins, Robert M Rennebohm |
Journal | Pediatric radiology
(Pediatr Radiol)
Vol. 42
Issue 12
Pg. 1481-9
(Dec 2012)
ISSN: 1432-1998 [Electronic] Germany |
PMID | 22940711
(Publication Type: Journal Article)
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Chemical References |
- Adrenal Cortex Hormones
- Antirheumatic Agents
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Topics |
- Adolescent
- Adrenal Cortex Hormones
(administration & dosage)
- Adult
- Antirheumatic Agents
(administration & dosage)
- Arthritis, Juvenile
(diagnostic imaging, drug therapy, epidemiology)
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Injections, Intra-Articular
(methods)
- Longitudinal Studies
- Male
- Ohio
(epidemiology)
- Prevalence
- Risk Factors
- Treatment Outcome
- Ultrasonography, Interventional
(statistics & numerical data)
- Young Adult
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