{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:29Z","timestamp":1787027069730,"version":"build-2736575974"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:00:00Z","timestamp":1648512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Juvenile idiopathic arthritis (JIA) is one of the common rheumatic diseases in pediatrics. Persistent synovitis and joint pain cause reduced range of motion, deformity and gait interruption, which are important reasons for children's disability and a decline in their quality of life. Rheumatology experts have explored good treatment strategies, among which intra-articular corticosteroid injections (IACIs) targeting joints can greatly reduce these systemic adverse reactions while still obtaining local anti-inflammatory effects. Local inhibition of synovitis by the use of steroid hormones in a joint cavity can avoid or reduce adverse reactions of systemic therapy, prevent or treat leg length variance and joint contracture, solve Baker's cyst, improve tenosynovitis, promote physical therapy and rehabilitation, make gait change smoothly, relieve pain, and restore joint function. Given the importance of IACIs in treating JIA, this paper reviewed the case selection, drug injection, dose selection, current anesthesia and injection techniques, the efficacy, recurrence, and influencing factors of IACIs, the management of physiotherapy intervention post-injection, the application of ultrasound guidance and the safety and complications of IACIs in children with JIA. This study aims to guide the use of IACIs for the best approach throughout the review.<\/jats:p>","DOI":"10.3389\/fped.2022.822009","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T01:16:43Z","timestamp":1648603003000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Application of Intra-articular Corticosteroid Injection in Juvenile Idiopathic Arthritis"],"prefix":"10.3389","volume":"10","author":[{"given":"Sha","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.reumae.2018.07.003","article-title":"Intra-articular joint injections in juvenile idiopathic arthritis: state of the art","volume":"15","author":"Nieto-Gonz\u00e1lez","year":"2019","journal-title":"Reumatol Clin"},{"key":"B2","first-page":"1918","article-title":"Variation in the initial treatment of knee monoarthritis in juvenile idiopathic arthritis: a survey of pediatric rheumatologists in the United States and Canada","volume":"34","author":"Beukelman","year":"2007","journal-title":"J Rheumatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s10067-007-0654-6","article-title":"Biologics for the treatment of juvenile idiopathic arthritis: a systematic review and critical analysis of the evidence","volume":"27","author":"Gartlehner","year":"2008","journal-title":"Clin Rheumatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1001\/jama.294.13.1671","article-title":"Medical treatment of juvenile idiopathic arthritis","volume":"294","author":"Hashkes","year":"2005","journal-title":"JAMA."},{"key":"B5","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1136\/adc.88.3.192","article-title":"Intra-articular corticosteroid injections in juvenile idiopathic arthritis","volume":"88","author":"Cleary","year":"2003","journal-title":"Arch Dis Child."},{"key":"B6","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1093\/oso\/9780192632920.003.0030","article-title":"Pharmacological treatment of early or established arthritis","volume-title":"Arthritis in Adolescents and Children (Juvenile Idiopathic Arthritis)","author":"Mallleson","year":"2006"},{"key":"B7","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1002\/acr.20460","article-title":"2011 American College of Rheumatology. Recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Clinician's guide","volume":"63","author":"Beukelman","year":"2011","journal-title":"Arthritis Care Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00296-010-1365-x","article-title":"Intra-articular corticosteroid therapy for juvenile idiopathic arthritis: report of an experiential cohort and literature review","volume":"31","author":"Bloom","year":"2011","journal-title":"Rheumatol Int"},{"key":"B9","first-page":"77481","article-title":"A reappraisal of intra-articular corticosteroid therapy in juvenile idiopathic arthritis","volume":"28","author":"Scott","year":"2010","journal-title":"Clin Exp Rheumatol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.clim.2011.10.003","article-title":"Evidence and consensus based GKJR guidelines for the treatment of juvenile idiopathic arthritis","volume":"142","author":"Dueckers","year":"2012","journal-title":"Clin Immunol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1093\/rheumatology\/keh313","article-title":"Triamcinolone acetonide and hexacetonide intra-articular treatment of symmetrical joints in juvenile idiopathic arthritis: a double-blind trial","volume":"43","author":"Zulian","year":"2004","journal-title":"Rheumatology."},{"key":"B12","first-page":"2507","article-title":"Comparison of the intraarticular effectiveness of triamcinolone hexacetonide and triamcinolone acetonide in treatment of juvenile rheumatoid arthritis","volume":"31","author":"Eberhard","year":"2004","journal-title":"J Rheumatol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1093\/rheumatology\/keg358","article-title":"Comparison of intra-articular triamcinolone acetonide in oligoartiuclar juvenile idiopathic arthritis","volume":"42","author":"Zulian","year":"2003","journal-title":"Rheumatology."},{"key":"B14","doi-asserted-by":"publisher","first-page":"374","DOI":"10.3899\/jrheum.110125","article-title":"A dose schedule for intraarticular steroids in juvenile arthritis","volume":"39","author":"Eberhard","year":"2012","journal-title":"J Rheumatol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/S0140-6736(07)60363-8","article-title":"Juvenile idiopathic arthritis","volume":"369","author":"Ravelli","year":"2007","journal-title":"Lancet."},{"key":"B16","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1038\/clpt.1986.45","article-title":"Pharmacokinetics and pharmacodynamics of glucocorticoid suspensions after intra-articular administration","volume":"39","author":"Derendorf","year":"1986","journal-title":"Clin Pharmacol Ther."},{"key":"B17","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1111\/j.1460-9592.2008.02903.x","article-title":"Clowns for the prevention of preoperative anxiety in children: a randomized controlled trial","volume":"19","author":"Golan","year":"2009","journal-title":"Pediatr Anaesth."},{"key":"B18","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1186\/1546-0096-9-S1-P118","article-title":"Medical clowns \u2013 dream doctors as important team members in the treatment of young children with juvenile idiopathic arthritis","volume":"151","author":"Oren-Ziv","year":"2012","journal-title":"Harefuah."},{"key":"B19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/1546-0096-8-3","article-title":"Anesthesia for intra-articular corticosteroid injections in juvenile idiopathic arthritis: a survey of pediatric rheumatologists","volume":"8","author":"Weiss","year":"2010","journal-title":"Pediatr Rheumatol Online J."},{"key":"B20","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s12969-015-0021-0","article-title":"Sedation methods for intraarticular corticosteroid injections in juvenile idiopathic arthritis: a review","volume":"13","author":"Oren-Ziv","year":"2015","journal-title":"Pediatr Rheumatol Online J."},{"key":"B21","first-page":"594","article-title":"Evaluation of eutectic lidocaine\/prilocaine cream (EMLA) for steroid joint injection in children with juvenile rheumatoid arthritis: a double blind, randomized,placebo controlled trial","volume":"30","author":"Uziel","year":"2003","journal-title":"J Rheumatol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12969-015-0034-8","article-title":"A randomized study of local anesthesia for pain control during intra-articular corticosteroid injection in children with arthritis","volume":"13","author":"Weiss","year":"2015","journal-title":"Pediatr Rheumatol Online J."},{"key":"B23","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1007\/s00431-013-2246-6","article-title":"Procedural sedation forintra-articular corticosteroid injections in juvenile idiopathic arthritis (JIA) should be a standard of care","volume":"173","author":"Pastore","year":"2014","journal-title":"Eur J Pediatr."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1007\/s00431-013-2052-1","article-title":"Sedation for intra-articular corticosteroid injections in juvenile idiopathicarthritis: the views of patients and their parents","volume":"172","author":"Casado","year":"2013","journal-title":"Eur J Pediatr."},{"key":"B25","doi-asserted-by":"publisher","first-page":"E47","DOI":"10.1542\/peds.105.4.e47","article-title":"Fixed 50% nitrous oxide oxygen mixture for painful procedures: a French survey","volume":"105","author":"Annequin","year":"2000","journal-title":"Pediatrics."},{"key":"B26","first-page":"28","article-title":"Utilisation antalgique du m\u00e9lange \u00e9quimol\u00e9culaire oxyg\u00e8ne protoxyde d'azote en p\u00e9diatrie [The use of a mixture of an equimolecular mixture of oxygen protoxide of nitrogen in pediatrics]","volume":"65","author":"Annequin","year":"2000","journal-title":"Rev Infirm"},{"key":"B27","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1136\/adc.86.6.416","article-title":"Nitrous oxide analgesia during intra-articular injection for juvenile idiopathic arthritis","volume":"86","author":"Cleary","year":"2002","journal-title":"Arch Dis Child."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1546-0096-6-1","article-title":"Nitrous Oxide sedation for intra-articular injection in juvenile idiopathic arthritis","volume":"6","author":"Uziel","year":"2008","journal-title":"Pediatr Rheumatol Online J."},{"key":"B29","first-page":"771","article-title":"Medical clowns facilitate nitrous oxide sedation during intra-articular corticosteroid injection for juvenile idiopathic arthritis","volume":"16","author":"Weintraub","year":"2014","journal-title":"Isr Med Assoc J."},{"key":"B30","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s12969-019-0312-y","article-title":"Efficacy and cost savings with the use of a minimal sedation \/ anxiolysis protocol for intra-articular corticosteroid injections in children with juvenile idiopathic arthritis: a retrospective review of prospectively collected data","volume":"17","author":"Elitsur","year":"2019","journal-title":"Pediatr Rheumatol Online J."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1002\/1529-0131(199807)41:7<1210::AID-ART10>3.0.CO","article-title":"Intraarticular corticosteroid injection in the management of children with chronic arthritis","volume":"41","author":"Padeh","year":"1998","journal-title":"Arthritis Rheum."},{"key":"B32","first-page":"264","article-title":"Feasibility and efficacy of intraarticular steroids (IAS) in juvenile idiopathic arthritis (JIA)","volume":"46","author":"Verma","year":"2009","journal-title":"Indian Pediatr."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1002\/1529-0131(199807)41:7<1210::AID-ART10>3.0.CO","article-title":"Intraarticular cor ticosteroid injection in the management of children with chronic arthritis","volume":"41","author":"Padeh","year":"1998","journal-title":"Arthritis Rheum."},{"key":"B34","doi-asserted-by":"publisher","first-page":"727","DOI":"10.2165\/00007256-200333100-00002","article-title":"Assessment and interpretation of isokinetic muscle strength during growth and maturation","volume":"33","author":"De Ste Croix","year":"2003","journal-title":"Sports Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1093\/rheumatology\/keh381","article-title":"Muscle involvement in juvenile idiopathic arthritis","volume":"43","author":"Lindehammar","year":"2004","journal-title":"Rheumatology."},{"key":"B36","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1111\/j.1651-2227.2004.tb02688.x","article-title":"Effect of joint injections in children with juvenile idiopathic arthritis: evaluation by 3D-gait analysis","volume":"93","author":"Brostr\u00f6m","year":"2004","journal-title":"Acta Pediatr."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1136\/ard.62.10.1013","article-title":"Randomised controlled study of post injection immobilization after intra-articular glucocorticoid treatment for wrist synovitis","volume":"62","author":"Weitoft","year":"2003","journal-title":"Ann Rheum Dis."},{"key":"B38","doi-asserted-by":"publisher","first-page":"37","DOI":"10.2147\/OARRR.S5103","article-title":"Intra-articular corticosteroids in the treatment of juvenile idiopathic arthritis: safety, efficacy, and features affecting outcome. A comprehensive review of the literature","volume":"1","author":"Gotte","year":"2009","journal-title":"Open Access Rheumatol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.1093\/rheumatology\/ker165","article-title":"Outcome and predicting factors of single and multiple intra-articular corticosteroid injections in children with juvenile idiopathic arthritis","volume":"50","author":"Lanni","year":"2011","journal-title":"Rheumatology."},{"key":"B40","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1123\/pes.25.2.221","article-title":"A feasibility study of the effect of intra-articular corticosteroid injection on isokinetic muscle strength in children with juvenile idiopathic arthritis","volume":"25","author":"McKay","year":"2013","journal-title":"Pediatr Exerc Sci."},{"key":"B41","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/1546-0096-12-23","article-title":"The clinical effectiveness of intra-articular corticosteroids for arthritis of the lower limb in juvenile idiopathic arthritis: a systematic review","volume":"12","author":"Jennings","year":"2014","journal-title":"Pediatr Rheumatol Online J."},{"key":"B42","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1016\/j.jcms.2020.06.010","article-title":"Effect of intra-articular corticosteroid injections on pain and mouth opening in juvenile idiopathic arthritis with temporomandibular involvement: a systematic review and meta- analysis","volume":"48","author":"Antonarakis","year":"2020","journal-title":"J Craniomaxillofac Surg."},{"key":"B43","first-page":"2696","article-title":"A sub-group specific evaluation of the efficacy of intra-articular triamcinolone hexacetonide in juvenile chronic arthritis","volume":"27","author":"Breit","year":"2000","journal-title":"J Rheumatol."},{"key":"B44","first-page":"2100","article-title":"Factors affecting the effificacy of intraarticular corticosteroid injection of knees in juvenile idiopathic arthritis","volume":"28","author":"Ravelli","year":"2001","journal-title":"J Rheumatol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.rbre.2016.01.001","article-title":"Intra-articular injection in patients with juvenile idiopathic arthritis: factors associated with a good response","volume":"56","author":"Cunha","year":"2016","journal-title":"Rev Bras Reumatol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1002\/acr.21947","article-title":"Delineating the role of multiple intraarticular corticosteroid injections in the management of juvenile idiopathic arthritis in the biologic era","volume":"65","author":"Papadopoulou","year":"2013","journal-title":"Arthritis Care Res"},{"key":"B47","doi-asserted-by":"publisher","first-page":"909e16","DOI":"10.1016\/S0140-6736(17)30065-X","article-title":"Intra-articular corticosteroids versus intra articular corticosteroids plus methotrexate in oligoarticular juvenile idiopathic arthritis: a multicentre,prospective, randomised, open-label trial","volume":"389","author":"Ravelli","year":"2017","journal-title":"Lancet."},{"key":"B48","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12969-019-0339-0","article-title":"Retrospective review of immobilization vs. immediate resumption of activity in patients with Oligoarticular juvenile idiopathic arthritis following knee injections","volume":"17","author":"Flanagan","year":"2019","journal-title":"Pediatr Rheumatol Online J"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.1007\/s00247-012-2487-y","article-title":"Ultrasound-guided corticosteroid injection therapy for juvenile idiopathic arthritis: 12-year care experience","volume":"42","author":"Young","year":"2012","journal-title":"Pediatr Radiol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1007\/s00247-015-3291-2","article-title":"Ultrasound-guided corticosteroid injection of the subtalar joint for treatment of juvenile idiopathic arthritis","volume":"45","author":"Young","year":"2015","journal-title":"Pediatr Radiol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12969-017-0155-3","article-title":"Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study","volume":"15","author":"Peters","year":"2017","journal-title":"Pediatr Rheumatol Online J."},{"key":"B52","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1546-0096-10-11","article-title":"Ultrasonography and color Doppler in juvenile idiopathic arthritis: diagnosis and follow-up of ultrasound-guided steroid injection in the wrist region. A descriptive interventional study","volume":"10","author":"Laurell","year":"2012","journal-title":"Pediatr Rheumatol Online J."},{"key":"B53","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12969-016-0096-2","article-title":"Ultrasound in juvenile idiopathic arthritis","volume":"14","author":"Magni-Manzoni","year":"2016","journal-title":"Pediatr Rheumatol Online J."},{"key":"B54","first-page":"719","article-title":"Treatment of juvenile idiopathic arthritis with intra-articular triamcinolone hexacetonide: evaluation of clinical effectiveness correlated with circulating ANA and T gamma\/delta + and B CD5+ lymphocyte populations of synovial fluid","volume":"20","author":"Lepore","year":"2002","journal-title":"Clin Exp Rheumatol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s00431-007-0525-9","article-title":"Factors influencing the efficacy of intra-articular steroid injections in patients with juvenile idiopathic arthritis","volume":"167","author":"Marti","year":"2008","journal-title":"Eur J Pediatr."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1093\/rheumatology\/kei154","article-title":"Secondary Cushing's syndrome in children with juvenile idiopathic arthritis following intra-articular triamcinolone acetonide administration","volume":"44","author":"Gondwe","year":"2005","journal-title":"Rheumatology."},{"key":"B57","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.semarthrit.2012.12.006","article-title":"Systemic adverse events following intraarticular corticosteroid injections for the treatment of juvenile idiopathic arthritis: two patients with dermatologic adverse events and review of the literature","volume":"43","author":"Goldzweig","year":"2013","journal-title":"Semin Arthritis Rheum."},{"key":"B58","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1111\/j.1440-1754.2006.00880.x","article-title":"Cushing syndrome, adrenal suppression and local corticosteroid use","volume":"42","author":"Hameed","year":"2006","journal-title":"J Paediatr Child Health."},{"key":"B59","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1097\/RHU.0000000000000146","article-title":"Livedoid dermatitis (Nicolau syndrome) following intra-articular glucocorticoid injection","volume":"20","author":"McKinney","year":"2014","journal-title":"J Clin Rheumatol."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.822009\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,19]],"date-time":"2023-11-19T06:46:37Z","timestamp":1700376397000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.822009\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,29]]},"references-count":59,"alternative-id":["10.3389\/fped.2022.822009"],"URL":"https:\/\/doi.org\/10.3389\/fped.2022.822009","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,29]]},"article-number":"822009"}}