Approach
Treatment is focused on relieving symptoms and decreasing the synovial inflammation. Activity restrictions, and even a short period of bed rest, can be employed. Non-steroidal anti-inflammatory drugs (NSAIDs) can be given for a short time with the appropriate precautions, such as discontinuation with any gastrointestinal symptoms. Ibuprofen has been shown to decrease the duration of symptoms.[19] Ketorolac may be considered in patients with severe pain or those unable to tolerate oral medications. While it is used clinically in children, it is not licensed for use in this patient group. Randomised placebo-controlled trials of ketorolac use in neonate, infant, and child populations are lacking, and data on efficacy and safety are low quality.[20][21] Paracetamol may be used if the patient is unable to take NSAIDs. Aspirin should be avoided due to concern regarding Reye's syndrome in paediatric patients.
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