Arthroscopic Treatment of an Juvenile Idiopathic Arthritis of the Wrist

Abstract

Juvenile idiopathic arthritis (JIA) comprises a group of arthritic diseases of various etiologies with onsets before 16 years of age. JIA is the most common chronic rheumatic condition in pediatric patients [1], [2]. The International League of Associations for Rheumatology 2001 classification of JIA includes the following subtypes: systemic-onset arthritis, oligoarthritis, extended oligoarthritis, polyarthritis (rheumatoid factor [RF]-negative), polyarthritis (RF-positive), psoriatic arthritis, enthesitis-related arthritis, and undifferentiated arthritis [3].

The wrist joint is the fourth most commonly affected joint in JIA, followed by the knee, ankle, and elbow joints [1]. Early involvement of the wrist joint has been established as a poor prognostic factor [1], [2], [3]. However, the role of arthroscopy in the JIA wrist is ambiguous.

We experienced a rare case of an adolescent patient with JIA who experienced chronic wrist pain associated with volar intercalated segment instability (VISI) deformity and was treated with arthroscopic synovectomy and temporary K-wire fixation correcting alignment. We herein report the clinical course and outcomes.