Joint Injections

Joint injections are a form of treatment for children with arthritis. We inject a high-dose steroid directly into the joint, most commonly the temporomandibular joint (TMJ), in the jaw, or the subtalar joint, in the foot.

Procedure

This procedure occurs in Interventional Radiology because these joints are difficult to locate, and the doctor must use ultrasound, live X-ray (fluoroscopy) or CT scan for guidance.

Using ultrasound, live X-ray or CT scan, the doctor will place a small needle into the affected joint. In some cases, the doctor then injects a small amount of X-ray dye (contrast) to confirm that the needle is within the joint. Once placement is confirmed, the doctor injects the liquid steroid medication. Then we will remove the needle and apply a bandage. The procedure should take less than one hour to complete.

A bandage will be applied to the injection site after the operation, and it must stay dry and in place for 24 hours. After 24 hours you may remove the clear bandage and gauze, or the Band-Aid®.

Anesthesia

Patients receive either IV sedation or general anesthesia and are asleep for this procedure.

Risks

This is considered a low-risk procedure. Potential complications include:

• bleeding
• infection
• allergic reaction to X-ray dye (contrast reaction)
• dimpling or paleness at the injection site
• nerve injury
• injury to the eardrum (with TMJ only)

Pain

Most patients do not experience pain or discomfort after the procedure. Some feel fullness in the joint for a few days until the liquid medication is absorbed. The procedure site may be tender to the touch. You may give your child over-the-counter pain medication.

The injection site may be swollen within the first 24 hours. The swelling should go down within three to five days.

Bathing

Your child can shower or take a bath after the bandage is removed.

Activity Restrictions

We suggest your child limits activity for 24 hours. Your child can go to day care or school but shouldn’t participate in sports or strenuous activity. This is especially true if the injection was in the foot.

If the TMJ was injected, your child should avoid hard, chewy foods for several days.