Ultrasound guided joint fluid aspiration and corticosteroid injection in patients with juvenile idiopathic arthritis (JIA)

Background Musculoskeletal ultrasound (US) is a rapidly evolving and powerful diagnostic modality, which is gaining popularity for the evaluation and management of joint damage and soft tissue diseases in children with JIA. Several studies have shown that clinical examination underestimates the presence of intra-articular fluid when compared to US. US guided aspiration allows direct observation of the joint effusion and needle placement and enables correct intraarticular corticosteroid injection avoiding the risk of steroid-induced subcutaneous atrophy. This contrasts X-ray guided techniques. In small joints such as MCP, PIP and MTP the effusion is mainly located proximal to the joint space.