Non-Surgical Procedure Eases Juvenile Arthritis Ankle Pain

More than 90 percent of image-guided steroid injections result in clinical improvement

WEDNESDAY, April 5 (HealthDay News) -- Fluoroscopically guided steroid injections in the ankle can help relieve symptoms of juvenile arthritis, according to research presented during the annual meeting of the Society of Interventional Radiology in Toronto.

Anne Marie Cahill, M.D., of the Children's Hospital of Philadelphia, and colleagues performed 55 image-guided subtalar joint injections in 38 children with juvenile idiopathic arthritis between 2000 and 2005. The researchers injected up to one milliliter of triamcinolone hexacetonide or acetonide into the mid subtalar joint.

Patients showed clinical improvement after 50 of the 55 injections, or 91 percent. The median time between a child's diagnosis and injection was 0.1 year, and improvement lasted a mean of 1.6 years. Children treated sooner responded significantly better, the researchers found. About half of the children had asymptomatic hypopigmentation or subcutaneous atrophy after injection and this was associated with the quantity of injected steroid, with a higher volume causing more complications.

"Fluoroscopically guided subtalar joint injection is an effective method for treatment of subtalar juvenile arthritis," the authors write. "Complications correlate well with the volume of steroid injected. Overall reduction in the volume of steroid injected in future practice should significantly reduce the complication rates. Prompt referral for intra-articular steroid injection will improve treatment response rates."


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