CASE REPORT : JUVENILE IDIOPATHIC ARTHRITIS

Abstract

Background: Juvenile rheumatoid arthritis, now more commonly known as juvenile idiopathic arthritis (JIA), is a chronic form of arthritis that occurs in children under 16 years of age. It is characterized by persistent inflammation in one or more joints for at least six weeks without an identifiable cause. Objective: Evaluate the clinical condition of a patient with polyarticular JIA who has received methotrexate therapy, and to assess the effectiveness of intra-articular triamcinolone acetonide as an adjunct treatment. Methods: This study based on a case illustration of a 4-year-old boy diagnosed with polyarticular JIA. Data were obtained through medical history, physical examination, methotrexate treatment records, and planned intra-articular injection procedures. A literature review was also conducted to evaluate the effectiveness of triamcinolone acetonide as adjunct therapy in polyarthritis. Results: The 4-year-old patient, weighing 18 kg and measuring 109 cm in height, had experienced symptoms for the past two years. Despite methotrexate therapy—gradually increased from 10 mg/m² to 15 mg/m² per week since December 2020—he continued to present with swelling in the hands and feet, stiffness in both knees and elbows, and pain that limited joint extension. Literature indicates that intra-articular triamcinolone acetonide demonstrates approximately 70% effectiveness in managing symptoms in patients with polyarticular JIA. Conclusions: JIA is a chronic inflammatory disease that requires comprehensive management. In this case, methotrexate alone did not fully alleviate symptoms, making additional therapy necessary. Intra-articular triamcinolone acetonide is effective and may serve as a viable option to improve joint function and reduce inflammation in polyarticular JIA.