Abstract
Introduction Juvenile Idiopathic Arthritis (JIA) is the most common rheumatological condition
in children and frequently affects the wrist. The roles for wrist arthroscopy and
arthroscopic synovectomy (AS) in JIA are unclear. Our aim was to find the current
evidence supporting its use.
Methods Systematic literature review of relevant publications from 1990 to present in the
Cochrane Library, Clinical Knowledge Summaries, DynaMed, PEMSoft, NICE Guidance, MEDLINE,
EMBASE, and PubMed.
Results We found no publications detailing the use of arthroscopy or AS specifically in patients
with JIA involving the wrist. There is evidence that AS reduces pain, improves function,
and induces remission in patients with rheumatoid arthritis resistant to medical management.
Discussion and Conclusion Although there is paucity in evidence for the use of AS in the wrists of patients
with JIA, studies suggest it to be safe and effective, and could be applied to patients
with refractive JIA. It is possible that early identification of patients suffering
from JIA with extensive joint destruction and little symptoms could benefit from AS,
delaying joint destruction and preserving function.
Keywords
juvenile idiopathic arthritis - wrist - arthroscopy - synovectomy
