Joint injection practice variations in pediatric rheumatology – a global survey and call for action
Abstract Background Intraarticular injections (IAI) were first reported in adult rheumatology in the 1950s and subsequently gained acceptance as a safe and efficacious treatment in Juvenile idiopathic arthritis (JIA). IAIs are now widely performed and recommended as the initial or only treatment of...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Pediatric Rheumatology Online Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12969-020-00475-0 |
| _version_ | 1818207979149721600 |
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| author | Anita Dhanrajani Raju P. Khubchandani |
| author_facet | Anita Dhanrajani Raju P. Khubchandani |
| author_sort | Anita Dhanrajani |
| collection | DOAJ |
| description | Abstract Background Intraarticular injections (IAI) were first reported in adult rheumatology in the 1950s and subsequently gained acceptance as a safe and efficacious treatment in Juvenile idiopathic arthritis (JIA). IAIs are now widely performed and recommended as the initial or only treatment of oligoarticular JIA and ancillary treatment of actively inflamed joints in other varieties of JIA. However, the performance of the procedure is currently not guided by standardized recommendations, and several practice variations are observed. Methods This worldwide survey of pediatric rheumatologists (with 48.5% response from Pediatric Rheumatology International Trials Organization [PRINTO and Pediatric Rheumatology Collaborative Study Group [PRCSG] members) captures the differences in pre-procedural, procedural and post-procedural protocols and practices observed across the globe and asks the necessity of developing consensus in this area of Pediatric Rheumatology. Results This worldwide survey of Pediatric Rheumatologists had a response rate of just under 50% and the views of about 42% who routinely performed the procedure. It captured the differences in IAI protocols and practices observed across the globe. Significant variations in practice were noted in use of Local anesthesia, choice, and dose of therapeutic agent for the intraarticular injection and use of ultrasound to guide injections. While some practice variations may be explained by institutional protocols in different parts of the world, the clinical implications of these are largely unknown and beg the need for further studies. Conclusions Given these practice variations, the authors recommend further studies to explore the cost and clinical implications and subsequently work towards developing consensus plans to ensure uniformity in this widely used procedure in Pediatric Rheumatology. |
| first_indexed | 2024-12-12T04:37:31Z |
| format | Article |
| id | doaj.art-f999bf1045f24a339ce2ac3590b500b3 |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-12-12T04:37:31Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-f999bf1045f24a339ce2ac3590b500b32022-12-22T00:37:55ZengBMCPediatric Rheumatology Online Journal1546-00962020-10-011811710.1186/s12969-020-00475-0Joint injection practice variations in pediatric rheumatology – a global survey and call for actionAnita Dhanrajani0Raju P. Khubchandani1Hospital for Sick ChildrenPediatric Rheumatology, SRCC Children’s HospitalAbstract Background Intraarticular injections (IAI) were first reported in adult rheumatology in the 1950s and subsequently gained acceptance as a safe and efficacious treatment in Juvenile idiopathic arthritis (JIA). IAIs are now widely performed and recommended as the initial or only treatment of oligoarticular JIA and ancillary treatment of actively inflamed joints in other varieties of JIA. However, the performance of the procedure is currently not guided by standardized recommendations, and several practice variations are observed. Methods This worldwide survey of pediatric rheumatologists (with 48.5% response from Pediatric Rheumatology International Trials Organization [PRINTO and Pediatric Rheumatology Collaborative Study Group [PRCSG] members) captures the differences in pre-procedural, procedural and post-procedural protocols and practices observed across the globe and asks the necessity of developing consensus in this area of Pediatric Rheumatology. Results This worldwide survey of Pediatric Rheumatologists had a response rate of just under 50% and the views of about 42% who routinely performed the procedure. It captured the differences in IAI protocols and practices observed across the globe. Significant variations in practice were noted in use of Local anesthesia, choice, and dose of therapeutic agent for the intraarticular injection and use of ultrasound to guide injections. While some practice variations may be explained by institutional protocols in different parts of the world, the clinical implications of these are largely unknown and beg the need for further studies. Conclusions Given these practice variations, the authors recommend further studies to explore the cost and clinical implications and subsequently work towards developing consensus plans to ensure uniformity in this widely used procedure in Pediatric Rheumatology.http://link.springer.com/article/10.1186/s12969-020-00475-0ArthritisJuvenileInjectionsIntra-articularSurveys and questionnaires |
| spellingShingle | Anita Dhanrajani Raju P. Khubchandani Joint injection practice variations in pediatric rheumatology – a global survey and call for action Pediatric Rheumatology Online Journal Arthritis Juvenile Injections Intra-articular Surveys and questionnaires |
| title | Joint injection practice variations in pediatric rheumatology – a global survey and call for action |
| title_full | Joint injection practice variations in pediatric rheumatology – a global survey and call for action |
| title_fullStr | Joint injection practice variations in pediatric rheumatology – a global survey and call for action |
| title_full_unstemmed | Joint injection practice variations in pediatric rheumatology – a global survey and call for action |
| title_short | Joint injection practice variations in pediatric rheumatology – a global survey and call for action |
| title_sort | joint injection practice variations in pediatric rheumatology a global survey and call for action |
| topic | Arthritis Juvenile Injections Intra-articular Surveys and questionnaires |
| url | http://link.springer.com/article/10.1186/s12969-020-00475-0 |
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