Purpose or Case Report: In pediatric patients with inflammatory arthritis, steroid injections of the joints are an important therapeutic tool to help augment or avoid systemic steroid treatment. In adult patients, fluoroscopy is often used for diagnostic and therapeutic joint injections. In pediatric patients, ultrasound is an excellent modality for joint injections as resolution is very good for superficial structures, there is no radiation, real time imaging can be performed with non-cooperative patients, and steroid dosage can be maximized in small joints without wasting space in the joint with confirmatory contrast, as with fluoroscopy. Pediatric ultrasound guided joint injections are not commonplace at every radiology practice, but with some training, it can be performed safely and effectively to provide patient care. The purpose of this exhibit is to familiarize the reader with proper technique for ultrasound-guided joint injections.
Methods & Materials: Introduction to ultrasound guided joint injections
o Basic ultrasound imaging features of juvenile idiopathic arthritis (JIA)
o Basic equipment and support needed for pediatric joint injections
Case based demonstration of joint specific ultrasound-guided injections
o Elbows
o Wrists
o MCP/IP joints
o SI joints
o Hips
o Knees
o Tibiotalar joints
o MTP/IP joints
Results: We review our experience performing ultrasound guided joint injections for pediatric rheumatology patients and describe safe techniques for providing this important therapeutic procedure.
Conclusions: Ultrasound is an ideal modality for pediatric joint injections. These therapeutic procedures improve patient’s symptoms and improve their quality of life. In this presentation, we demonstrate our experience with ultrasound guided joint injections and demonstrate how therapeutic ultrasound guided joint injections can be easily adopted into a general pediatric radiologist’s practice.