Intra-articular or joint injections are a well established method of treating active arthritis in adults and children. In some children joint injection is all that will be required to control the disease but in some patients they need to be repeated when the disease flares.
Joint injections have the benefit of treating the inflammation in the affected joint by delivering the steroid medication directly to the site if inflammation thus avoiding unwanted “systemic” side effects to other parts of the body (see corticosteroid side effects sheet). Much like an asthma puffer delivers medication directly to the lungs.
Joint injections are also sometimes used in combination with other medications taken by mouth or by injection in patients with some forms of JIA but this decision is one that will be discussed with you taking into account your’s or your child’s particular circumstances.
Joint injections are very effective in treating arthritis in a single or multiple joints and are successful in over 90% of cases in settling the inflammation. The benefit lasts up to 2 years in around 60% but only in the joint that is injected. This means that an injection to the knee will not protect the other knee or ankles etc from developing arthritis.
In adult rheumatology practice joint injections are often done in the doctor’s office with minimal anaesthesia or pain control but paediatric rheumatologists feel that as children are not small adults they deserve some improved pain relief for the procedure. Some children require a general anaesthetic which puts them to sleep while others can have the procedure performed awake with some mild sedation and diversional or play therapy assistance.
The joint injection will in almost all cases require a hospital admission lasting around 4 hours and the patient is asked to avoid strenuous activity for 24 hours after the injection but may return to school or other activities the following day.
The sheets below include more information about joint injections including the risks of the procedure and Dr Singh-Grewal will be happy to discuss your concerns prior to the decision to undertake joint injections