EVALUATING THE ROLE OF INTRA-ARTICULAR CORTICOSTEROID INJECTIONS IN THE MANAGEMENT OF JUVENILE IDIOPATHIC ARTHRITIS IN CHILDREN

Abstract

Background: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatologic condition in children, often leading to joint damage and disability if not promptly treated.  Objective: To assess the therapeutic response, duration of remission, and adverse events associated with intra-articular corticosteroid injections in pediatric patients diagnosed with JIA. Methods: This descriptive observational study was conducted at Fauji Foundation Hospital Lahore from Oct 2024 to March 2025. A total of 76 children diagnosed with JIA, who received intra-articular corticosteroid injections were included. Data were collected through the Non-probability consecutive sampling technique. Information included age, gender, JIA subtype, duration of disease, joints injected, corticosteroid preparation and dose used, method of injection, need for sedation, and response to treatment. Results: Among 76 patients, the majority were female (68.4%) with a mean age of 9.2 ± 3.6 years. Oligoarticular JIA was the most common subtype (53.9%). The knee was the most frequently injected joint (61.8%), and triamcinolone hexacetonide was used in 89.5% of cases. Complete remission was achieved in 76.3% of patients, partial response in 14.5%, and no response in 9.2%. The mean duration of remission was 4.7 ± 1.8 months. Recurrence occurred in 25% of cases, and 15.8% required repeat injections. Mild adverse effects were noted in 5.3% of patients. Significant associations were found between treatment response and JIA subtype (p = 0.01), as well as steroid type (p = 0.04). Conclusion: Intra-articular corticosteroid injections are a safe, effective, and well-tolerated treatment for children with JIA, particularly in oligoarticular cases. Triamcinolone hexacetonide showed superior outcomes in inducing sustained remission.