US Guided Interventional Procedures in Paediatrics

Ultrasound imaging guidance of needles introduced for the purpose of joint aspiration or joint injection is becoming increasingly popular. The use of ultrasound increases the safety and efficacy of joint injections in pediatric rheumatology. Needle guidance may be important for diagnostic purposes (fluid aspiration) as well as injections in juvenile idiopathic arthritis (JIA) for short-term relief via intraarticular corticosteroid (CS) injections or longer-term management of limited disease and treatment-resistant multi-joint disease. Ultrasound guidance can also be used to inject steroids into tendon sheaths or around entheses in inflammatory conditions. The following chapter gives an overview of typical indications for ultrasound-guided intraarticular injections in pediatric rheumatology and describes the procedures used for ultrasound guidance of CS injections in specific anatomic regions.