Intraarticular corticosteroids for chronic arthritis in children: Efficacy and effects on cartilage and growth

Objectives: To assess the efficacy and effects on cartilage and statural growth of intraarticular corticosteroid (IAS) therapy for chronic arthritis in children and adolescents. Methods: We examined 21 children and adolescents with chronic arthritis (median duration, 8 months) that did not respond to nonsteroidal antiinflammatory drugs. The 21 joints injected with triamcinolone-hexacetonide were examined before and 7 weeks after IAS therapy by gadolinium-enhanced magnetic resonance imaging; 14 joints were also examined 13 months after IAS therapy. Results: All joints treated with IAS had improvement. Magnetic resonance imaging showed long-lasting suppression of inflammation and pannus without evidence of toxic effects on cartilage. Statural growth was not affected. Conclusion: In experienced hands, IAS therapy may be a safe and effective tool in the treatment of chronic arthritis in childhood. Long-term follow-up is mandatory. (J PEDIATR 1995;127:317-21)