Arthrocentesis and intraarticular corticosteroid (IACS) administration are simple procedures but often not performed by pediatricians. Hesitancy in executing this procedure may result in delayed diagnosis of underlying arthritis, and often delays the therapeutic benefit of IACS. The most common indication of IACS injection is Juvenile idiopathic arthritis (JIA), particularly oligoarticular JIA. We are sharing this video (Fig. 1 and Web Video 1) to increase awareness among pediatricians about this elementary technique. The video depicts the procedure of administrating IACS in a 9-year-old- boy diagnosed as JIA with active arthritis in left knee joint. The procedure was completed without any complication and there was symptomatic improvement in pain and swelling resulting in full range of motion at knee joint without any recurrence at last follow-up (2 months after the procedure).

Fig. 1 Intra-articular corticosteroid administration.

IACS injection is a daycare procedure and does not require specialized equipments for most of the amenable joints. Triamcinolone acetonide is available in India for IACS injection, and the usual dose is 2 mg/kg for large joints and 1-2 mg/joint for smaller joints. We usually prefer medial retropatellar approach for knee joint. A 21 or 22G needle attached to 10 mL syringe is advanced through skin, capsule, and synovial membrane to enter the joint cavity. A ’pop’ sensation and aspiration of synovial fluid confirms the right position. After aspiration, the syringe is detached while leaving the needle in place, and the IACS loaded in a prefilled syringe is administered. The needle is swiftly withdrawn, a gentle pressure is applied for 30 seconds, and a sterile bandaid is applied. Joint rest is advised for 48 h after injection to reduce the escape of medicine from the joint, and improving its anti-inflammatory response.