PMID- 31299977
OWN - NLM
STAT- MEDLINE
DCOM- 20200121
LR  - 20200225
IS  - 1546-0096 (Electronic)
IS  - 1546-0096 (Linking)
VI  - 17
IP  - 1
DP  - 2019 Jul 12
TI  - Retrospective review of immobilization vs. immediate resumption of activity in 
      patients with Oligoarticular juvenile idiopathic arthritis following knee 
      injections.
PG  - 42
LID - 10.1186/s12969-019-0339-0 [doi]
LID - 42
AB  - BACKGROUND: Intraarticular corticosteroid injection (IACI) is one of the most 
      common treatments in oligoarticular Juvenile Idiopathic Arthritis (JIA). Activity 
      recommendations following injection vary, as there are no published studies on 
      splinting JIA patients post-IACI (splinting is a form of rest). Texas Scottish 
      Rite Hospital for Children (TSRH) splints patients post-IACI for 24 h while The 
      Children's Hospital of Philadelphia (CHOP) does not. The aim of this study was to 
      compare the number of cases of recurrent arthritis following IACI between these 
      two post-injection practices. METHODS: Data were retrospectively collected at 
      CHOP and TSRH. Patients diagnosed with oligoarticular JIA according to 
      International League of Associations for Rheumatology (ILAR) criteria (2nd 
      revision, 2001) between 2008 and 2010 were included. Bivariate analysis (Wilcoxon 
      rank-sum tests, chi-squared tests) was run to assess differences in outcomes by 
      site. Inverse probability of treatment weighted Cox regression was employed to 
      adjust for site differences. RESULTS: The population at TSRH was younger than at 
      CHOP (p < 0.05) and had more whites (p = 0.03). Disease duration was 
      significantly longer at TSRH than at CHOP (0.40 vs. 0.74 years, p = 0.014). More 
      children were on biologics at the time of injection at CHOP (p < 0.05). The 
      baseline physician global (p < 0.001) was higher at CHOP, as was the joint 
      disease severity (p < 0.001). CHOP had fewer reoccurrences of knee arthritis 
      compared to TSRH: 26% vs 38% (p = 0.14). CONCLUSIONS: The baseline populations 
      were different in that the TSRH group had more whites and Hispanics, were younger 
      and, perhaps, had less severe disease than CHOP. Patients treated with 
      post-injection splinting had a trend toward more arthritis reoccurrence (38% vs. 
      26%, p = 0.14). Splinting is not clearly beneficial post-injection. TRIAL 
      REGISTRATION: This is an observational study, so it is not applicable.
FAU - Flanagan, Elaine R
AU  - Flanagan ER
AUID- ORCID: 0000-0003-0988-583X
AD  - Children's Healthcare of Atlanta/Emory University, Atlanta, GA, USA. 
      elaine.flanagan@emory.edu.
FAU - Benham, Heather
AU  - Benham H
AD  - Texas Scottish Rite Hospital, Dallas, TX, USA. Heather.Benham@tsrh.org.
FAU - Figueroa, Janet
AU  - Figueroa J
AD  - Children's Healthcare of Atlanta/Emory University, Atlanta, GA, USA.
FAU - Diaz, Janille
AU  - Diaz J
AD  - Children's Hospital of Philadelphia, Philadelphia, PA, USA.
FAU - Tress, Jenna
AU  - Tress J
AD  - Children's Hospital of Philadelphia, Philadelphia, PA, USA.
FAU - Sherry, David D
AU  - Sherry DD
AD  - Children's Hospital of Philadelphia, Philadelphia, PA, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20190712
PL  - England
TA  - Pediatr Rheumatol Online J
JT  - Pediatric rheumatology online journal
JID - 101248897
RN  - 0 (Anti-Inflammatory Agents)
RN  - F446C597KA (Triamcinolone Acetonide)
RN  - I7GT1U99Y9 (triamcinolone hexacetonide)
SB  - IM
MH  - Activities of Daily Living
MH  - Anti-Inflammatory Agents/*therapeutic use
MH  - Arthritis, Juvenile/*drug therapy
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - *Immobilization
MH  - Injections, Intra-Articular/*methods
MH  - *Knee Joint
MH  - Male
MH  - Retrospective Studies
MH  - *Splints
MH  - Triamcinolone Acetonide/*analogs & derivatives/therapeutic use
PMC - PMC6626321
OTO - NOTNLM
OT  - JIA splint
OT  - Joint injection
OT  - Knee injection
OT  - Oligoarticular juvenile idiopathic arthritis
COIS- The authors declare that they have no competing interests.
EDAT- 2019/07/14 06:00
MHDA- 2020/01/22 06:00
PMCR- 2019/07/12
CRDT- 2019/07/14 06:00
PHST- 2019/02/01 00:00 [received]
PHST- 2019/06/12 00:00 [accepted]
PHST- 2019/07/14 06:00 [entrez]
PHST- 2019/07/14 06:00 [pubmed]
PHST- 2020/01/22 06:00 [medline]
PHST- 2019/07/12 00:00 [pmc-release]
AID - 10.1186/s12969-019-0339-0 [pii]
AID - 339 [pii]
AID - 10.1186/s12969-019-0339-0 [doi]
PST - epublish
SO  - Pediatr Rheumatol Online J. 2019 Jul 12;17(1):42. doi: 10.1186/s12969-019-0339-0.