This leaflet aims to answer questions and help parents to understand why their child needs a joint injection. It also explains the effectiveness and possible side effects of treatment.

What is it?

A joint injection involves an injection of a steroid medicine into the joint space of an inflamed joint. This may be done under local anaesthetic, general anaesthetic or with the use of Entonox (gas and air) depending on the age and ability of the child to tolerate the procedure.

When is this treatment used?

This treatment is used in arthritis that has not settled adequately with non-steroidal anti-inflammatory drugs, such as Naproxen. Following injection your child should continue to take non-steroidal anti-inflammatory medications as directed by your doctor.

How effective is this treatment?

Most children respond very well to joint injections with relief of swelling and pain in a short period of time. Children with oligoarticular Juvenile Idiopathic Arthritis (affecting four or less joints) and those in whom arthritis has been present for only a short period, generally respond very well with the arthritis going away completely for 3 – 12 months, occasionally much longer. Approximately 50% of children who receive joint injections remain free of disease for at least 6 months. Only a very small number of children do not respond to this treatment at all.

 What if my child has to have a general anaesthetic?

 Children under eight or those who are having multiple joint injections usually have these done under a general anaesthetic. Arrangements will be made for your child to be admitted to hospital. You will receive instructions from the hospital about one week before and this will include advice on missing food/drink before the procedure.

Your child does not have to stay overnight in the hospital. Sometimes a cast is put on the limb for a day or two after the injection to rest the joint. Your physiotherapist and doctor will make arrangements for when and where to have the case removed.

Are there any precautions we should take after a joint injection?

Your child should rest for the first 24 hours following the joint injection. Following this regular activities should be resumed, this includes going to school, taking part in PE.

1. Subcutaneous fat atrophy (loss of fat under the skin) at the site of injection is an uncommon complication. This usually presents as a small dimple at the injection site and may resolve over time. Sometimes the skin at the same site loses its normal pigmentation (skin colour) as well.

2. Infection of the injected joint is very rare. If after the injection your child develops a very painful, swollen, hot and red joint, then you should contact the Paediatric Rheumatology Sisters or your GP urgently, i.e. the same day.

You can contact:

Paediatric Rheumatology Sisters
Ruth Wyllie
Barbara Gilbert
(0191 2820373)
(9.00 am – 5.00 pm Monday – Friday)

Secretary Terry Bell
(0191 2825318)
(9.00 am – 5.00 pm Monday – Friday)

Mr M Clarke, Consultant Ophthalmologist
(0191 2824002)
(9.00 am – 5.00 pm Monday – Friday)

Ward 17 Freeman Hospital
(0191 2826017)

Ward 9 RVI
(0191 282 5009)