Intraarticular corticosteroids for chronic arthritis in children: efficacy and effects on cartilage and growth.
OBJECTIVE
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.


CONCLUSIONS
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.
Huppertz
H I
HI
Children's Hospital, University of Würzburg, Germany.
Tschammler
A
A
Horwitz
A E
AE
Schwab
K O
KO
D000293:Adolescent; D000843:Ankle Joint / Q000187:drug effects; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000473:pathology; D002358:Cartilage, Articular / Q000187:drug effects* / Q000473:pathology; D002648:Child; D003287:Contrast Media; D004551:Elbow Joint / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006128:Growth / Q000187:drug effects*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000187:drug effects; D008279:Magnetic Resonance Imaging; D008297:Male; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D013997:Time Factors; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide; D019786:Gadolinium DTPA