Evaluation of MR imaging guided steroid injection of the sacroiliac joints for the treatment of children with refractory enthesitis-related arthritis

Jan Fritz, N. Tzaribachev, C. Thomas, J. A. Carrino, C. D. Claussen, J. S. Lewin, P. L. Pereira

Research output: Contribution to journalArticle

Abstract

Objectives: To test the hypothesis that MR imaging guided triamcinolone acetonide injection into the sacroiliac joints of children with enthesitis-related arthritis is feasible, accurate and safe; and effectively reduces sacroiliac inflammation and disease progression. Methods: A retrospective analysis of 14 children (6/14 [43%] female, 8/14 (57%) male; mean age, 13.2 years; range, 6-16 years) who received MR imaging guided sacroiliac joint injections at 0.2 Tesla or 1.5 Tesla for enthesitis-related arthritis and acute sacroilitis refractory to medical therapy was performed. 20 mg triamcinolone acetonide were injected. Assessed were intra-articular drug delivery; image quality, duration, and complications. Success of therapy was defined by change of sacroiliac inflammation. Remission time and erosions were assessed by follow-up MRI (range, 10-22 months). Results: Twenty four procedures resulted in intra-articular injection. Image quality was sufficient. No complications occurred. Procedure time was 40 min. Sedation time was 22 min. Success of therapy was achieved in 11/14 (79%) children. Sacroiliac inflammation decreased significantly (-59%). Median remission time was 13.7 months. No erosions occurred. Conclusions: MR imaging guided steroid injection of the sacroiliac joints is feasible, accurate, and safe and can effectively reduce sacroiliac inflammatory activity and may therefore aid in the prevention of disease progression.

Original languageEnglish (US)
Pages (from-to)1050-1057
Number of pages8
JournalEuropean Radiology
Volume21
Issue number5
DOIs
StatePublished - May 2011

Fingerprint

Sacroiliac Joint
Arthritis
Steroids
Triamcinolone Acetonide
Injections
Inflammation
Disease Progression
Intra-Articular Injections
Therapeutics
Joints
Pharmaceutical Preparations

Keywords

  • Enthesitis-related arthritis
  • Interventional magnetic resonance imaging
  • Sacroiliac joint injection
  • Sacroiliac joints
  • Sacroilitis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Evaluation of MR imaging guided steroid injection of the sacroiliac joints for the treatment of children with refractory enthesitis-related arthritis. / Fritz, Jan; Tzaribachev, N.; Thomas, C.; Carrino, J. A.; Claussen, C. D.; Lewin, J. S.; Pereira, P. L.

In: European Radiology, Vol. 21, No. 5, 05.2011, p. 1050-1057.

Research output: Contribution to journalArticle

Fritz, Jan ; Tzaribachev, N. ; Thomas, C. ; Carrino, J. A. ; Claussen, C. D. ; Lewin, J. S. ; Pereira, P. L. / Evaluation of MR imaging guided steroid injection of the sacroiliac joints for the treatment of children with refractory enthesitis-related arthritis. In: European Radiology. 2011 ; Vol. 21, No. 5. pp. 1050-1057.
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abstract = "Objectives: To test the hypothesis that MR imaging guided triamcinolone acetonide injection into the sacroiliac joints of children with enthesitis-related arthritis is feasible, accurate and safe; and effectively reduces sacroiliac inflammation and disease progression. Methods: A retrospective analysis of 14 children (6/14 [43{\%}] female, 8/14 (57{\%}) male; mean age, 13.2 years; range, 6-16 years) who received MR imaging guided sacroiliac joint injections at 0.2 Tesla or 1.5 Tesla for enthesitis-related arthritis and acute sacroilitis refractory to medical therapy was performed. 20 mg triamcinolone acetonide were injected. Assessed were intra-articular drug delivery; image quality, duration, and complications. Success of therapy was defined by change of sacroiliac inflammation. Remission time and erosions were assessed by follow-up MRI (range, 10-22 months). Results: Twenty four procedures resulted in intra-articular injection. Image quality was sufficient. No complications occurred. Procedure time was 40 min. Sedation time was 22 min. Success of therapy was achieved in 11/14 (79{\%}) children. Sacroiliac inflammation decreased significantly (-59{\%}). Median remission time was 13.7 months. No erosions occurred. Conclusions: MR imaging guided steroid injection of the sacroiliac joints is feasible, accurate, and safe and can effectively reduce sacroiliac inflammatory activity and may therefore aid in the prevention of disease progression.",
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