This procedure involves injecting steroid medication into the joint space. It will help decrease inflammation in the joint. Once the inflammation is under control, stiffness, swelling and motion will improve.

Steroid injections are done in the Rheumatology Clinic by your doctor, in Interventional Radiology by an interventional radiologist, or in the operating room under general anesthesia by a rheumatologist.

Before the Procedure

Children who do not need general anesthesia or sedation may eat and drink until the time of the procedure. If the child will be under anesthesia or sedation, a staff member will call you with specific instructions regarding food and drink at the time of scheduling. It is best for your child to wear loose-fitting clothes for this procedure.

During the Procedure

If your child will be awake during the procedure, they can watch TV or listen to music, or a Child Life specialist will be there with books, toys, Ipads, etc.

If the procedure is done in Interventional Radiology or the operating room, the doctor will use image guidance, with fluoroscopy (a moving X-ray) or ultrasound, to see the affected joint space. This helps guide the steroid medication into the joint space.

Your child’s skin may be numbed with a special cream before the steroid medicine is injected. The skin is cleaned and a small needle, with more numbing medicine, is inserted into the skin over the joint. Once the skin is numb, then another needle will be inserted into the joint and joint fluid will be removed if possible. After joint fluid is removed, then the steroid medicine is then injected into the joint through the same needle.

After the Procedure

Your child will need to rest and stay off the affected joint when they get home. You will get specific instructions from your child's doctor prior to the procedure. The reason for resting and not using the joint is to allow the steroid to stay in the joint longer, so the benefit of the injection will last longer. Your child should not experience any drainage, redness, warmth or extreme pain at the injection site.

Call your child's doctor if you notice any of these things at the injection site:

• Drainage
• Swelling
• Redness
• Warmth
• Extreme pain