Children and young people having an injection into a joint under general anaesthetic

This leaflet is a guide to your child or young person coming to Cambridge University Hospitals for a steroid joint injection under general anaesthetic.

Having a general anaesthetic

Children and young people may need to have a general anaesthetic when having an injection into a joint. This means that they will be given a special mix of medications that will make them sleep through the procedure. Please see our accompanying leaflet ‘Information for parents whose child is having an operation’ for more details about this part of the procedure. Your child will be asleep for a very short period of time, and the whole admission should take around four hours, depending on how the child recovers from the anaesthetic.

If you would like to see what happens as a child or young person goes off to sleep from a general anaesthetic, please see What? Why? Children in Hospital's video (opens in a new tab).

The injection

If your child or young person has a small number of joints affected by arthritis, this may be treated with an injection of steroid medication, known as a ‘corticosteroid’, given under anaesthetic directly into the painful swollen joint. This is beneficial because:

• Steroids reduce pain and swelling caused by arthritis.
• Excess fluid around the joint can be removed at the same time, where possible.
• Giving the steroids directly into the joint reduces the risk of side effects on other parts of the body.
• The injection works quickly to make the joint more comfortable.
• Results can last for months or often longer.
• If the effects of the injection wear off, it can be repeated if your doctor advises that this is appropriate. There may be a minimum time period of three months before the next injection can be given.

Some injections require x-ray guidance to ensure the correct placement of the medication into the joint. If this is the case, this will be explained to you prior to the procedure.

After the injection

• It is important that your child rests for 24 hours; after this time they can return to normal activities. You will need to acquire a wheelchair (or bring their pushchair) on your way into the hospital, or prior to leaving, as the child must not walk immediately after the procedure.
• Your child might require simple pain relief for the first 48 hours.

Side effects

Possible side effects of the injectable corticosteroid include:

• Risk of infection inside the joint. This is a very small risk and the health professional performing the procedure will take every care to use sterile (clean) techniques. See ‘When to seek medical attention’ section below.
• Thinning of the fat layer under the skin over the joint injection site can occur. This may result in an appearance like a small scar which can emerge a few months after the procedure.
• Steroids injected into joints can sometimes be seen as deposits on x-rays. This does not cause pain or affect the function of the joint.

When to seek medical attention

Monitor the child or young person closely for 24 to 48 hours after the joint injection. If they suffer a high temperature (fever), redness to the area, or pain which is getting worse over the injection site and/or around the injected joints, seek immediate medical advice. If this is out of hours, please contact NHS 111 (opens in a new tab).

If you have any questions or concerns, please contact the Paediatric Rheumatology advice line between 08:00 (8am) and 16:00 (4pm) Monday to Friday on 01223 254988, or email paediatric rheumatology (opens in a new tab).