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Oxford University Hospitals NHS Foundation Trust
OxPARC

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Joint injections

This is a routine procedure for children and teenagers with arthritis, both early and later in the disease.

It is used to take off fluid (to help with diagnosis and sometimes pain), but more often as a principle form of treatment by putting steroids just where they are needed.

What is done during a joint injection?

Joint injections are performed:

  • In clinic in older children and teenagers
  • On the ward if there is not enough time in clinic
  • In theatre under a general anaesthetic for young children

For most patients, the skin is numbed using a cream applied half an hour beforehand or an icey cold anaesthetic spray.

After the skin surface is thoroughly cleaned, the joint is entered with a sterile needle attached to a syringe. Fluid may be taken off. Then, if used, the steroid (a milky white solution) is injected into the joint space.

What benefit is derived from a joint injection?

If the steroid is injected there may be complete or partial relief of pain and swelling.

The improvement may be felt within 6 hours and is most noticeable over the following day or two.

What are the risks with joint injections?

Some discomfort may be felt afterwards and we recommend taking ibuprofen or diclofenac. The joint should also be rested for 24 hours afterwards.

Side effects are uncommon. Infection and an allergic response to steroid preservatives can result in a hot red painful joint, but are very rare. The allergic response settles within 24 hours with ibuprofen. An infection needs antibiotics.

Sometimes the steroid will ooze back along the needle track and affect the overlying skin. A small area of skin may become pale (lose pigment) and thin (lose fat content).

Are there situations where a joint injection should not be given?

Yes, if there is infection in or around a joint and if there has been a serious allergic reaction to a previous joint injection.

Joint injections information sheet (pdf; 33 KB)