Effectiveness of steroid intra-articular injections on functioning in children and adolescents affected by juvenile idiopathic arthritis: a systematic review

Introduction: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and steroid intra-articular injections are a fundamental treatment modality among local therapeutic interventions. The aim of this systemic review was to assess the scientific evidence on the effectiveness and safety of intra-articular corticosteroids (IACS) injections, focusing on a comparative examination of the different therapeutic options. Material and methods: PubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2025, to identify observational studies presenting participants with a diagnosis of JIA, IACS injections for joints affected by arthritis as interventions, and clinical or radiological assessment of arthritis as outcomes. Conclusions: Findings from this systematic review suggested that IACS injections might be effective in improving arthritis in patients affected by JIA, with good evidence of safety. Moreover, the review underlines a higher efficacy of triamcinolone hexacetonide among corticosteroids used for injections. Further studies with a higher level of evidence and more representative samples should be conducted.  What is Known: • Juvenile idiopathic arthritis is the most prevalent chronic rheumatic condition in childhood and represents a major cause of disability. • The management of juvenile idiopathic arthritis involves a variety of therapeutic modalities, among which intra-articular corticosteroid injections. What is new: • Intra-articular corticosteroid injections induce rapid symptom control and prolonged remission in a substantial proportion of patients. • Among different types of corticosteroids, triamcinolone hexacetonide is more effective in prolonging remission duration in JIA.