title: Intra-articular injection in patients with juvenile idiopathic arthritis: factors associated with a good response.
abstract: BACKGROUND
  Intra-articular injection of corticosteroids (IIC) for treatment of patients with juvenile idiopathic arthritis (JIA) is increasingly used in Pediatric Rheumatology.
  
  
  OBJECTIVE
  To describe the clinical course of patients undergoing IIC in our Pediatric Rheumatology Unit.
  
  
  METHODS
  Retrospective study of patients with JIA undergoing IIC from January 2008 to December 2012, with a minimum follow-up of six months after the injection. Good response to IIC was set as the presence of inactivity on the infiltrated joint by at least six months.
  
  
  RESULTS
  Eighty-eight patients underwent a total of 165 IICs. Of these, 75% were girls and 35.2% had persistent oligoarticular JIA. The mean age at diagnosis was 6.8 years, and when IIC was carried out, 12.2 years. Regarding patients, younger age at diagnosis (p=0.037) and the occurrence of uveitis in the course of the disease (p=0.015) were associated with good response to IIC. From 165 IICs, 63% had a good response and joints remained inactive for a median of 18.1 months. The type of joint injection (p=0.001), lesser values stated in the overall visual analog scale by the physician (p=0.015) and by parents/patient (p=0.01) have been associated with a good response to IIC. Nine adverse events (5.4%) were observed.
  
  
  CONCLUSIONS
  In our study, more than half of the joints showed a good response to IIC. Younger patients at diagnosis and uveitis during the course of the disease had good response to IIC. Knees, wrists and elbows were the joints that best responded to IIC. IIC proved to be a safe procedure.
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil. Electronic address: analuiza.cunha@gmail.com.
authors.forename: Ana Luiza Garcia
authors.initials: AL
authors.lastname: Cunha
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil; Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Vanessa Bugni
authors.initials: VB
authors.lastname: Miotto E Silva
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil.
authors.forename: Fabiane Mitie
authors.initials: FM
authors.lastname: Osaku
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Luísa Brasil
authors.initials: LB
authors.lastname: Niemxeski
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, Disciplina de Reumatologia, São Paulo, SP, Brazil.
authors.forename: Rita Nely Vilar
authors.initials: RN
authors.lastname: Furtado
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, Disciplina de Reumatologia, São Paulo, SP, Brazil.
authors.forename: Jamil
authors.initials: J
authors.lastname: Natour
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil; Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Maria Teresa de
authors.initials: MT
authors.lastname: Sande
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil; Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Lemos Ramos Ascensão
authors.initials: LR
authors.lastname: Terreri
mesh_terms: D001171:Arthritis, Juvenile / Q000188:drug therapy*; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: Artrite idiopática juvenil; Hexacetonido de triancinolona; Infiltração intra-articular; Intra-articular injection; Juvenile idiopathic arthritis; Tratamento e uveíte; Treatment and uveitis; Triamcinolone hexacetonide