Arthrocentesis

Arthrocentesis is a medical procedure that involves the insertion of a needle into a joint space to remove fluid, known as synovial fluid, for diagnostic or therapeutic purposes.

Purpose

The primary purpose of arthrocentesis is to:

• Diagnose joint diseases, such as arthritis, by analyzing the synovial fluid for signs of inflammation, infection, or other abnormalities.
• Relieve pressure and pain in the joint caused by excess fluid accumulation, a condition known as effusion.
• Administer medications, such as corticosteroids or hyaluronic acid, directly into the joint to reduce inflammation and promote healing.

Procedure

The arthrocentesis procedure typically involves the following steps:

1. The patient is positioned in a comfortable position, with the affected joint exposed and easily accessible.
2. The skin over the joint is cleaned and disinfected to minimize the risk of infection.
3. A local anesthetic may be administered to numb the area and reduce discomfort.
4. A needle is inserted into the joint space, and fluid is aspirated (removed) using a syringe.
5. The fluid sample may be sent to a laboratory for analysis, or medications may be injected into the joint through the same needle.
6. The needle is removed, and the site is bandaged to prevent bleeding and promote healing.

Indications

Arthrocentesis is commonly performed on patients with:

• Osteoarthritis
• Rheumatoid arthritis
• Psoriatic arthritis
• Gout
• Septic arthritis (infection of the joint)
• Hemarthrosis (bleeding into the joint)

Contraindications

Arthrocentesis is generally contraindicated in patients with:

• Bleeding disorders or taking anticoagulant medications
• Prosthetic joints or other artificial implants in the affected joint
• Active infection of the skin over the joint
• Prior allergic reactions to local anesthetics or other medications used during the procedure

Risks and Complications

As with any invasive medical procedure, arthrocentesis carries some risks and potential complications, including:

• Infection of the joint or skin
• Bleeding or hematoma (bruising) at the needle site
• Nerve damage or numbness
• Temporary pain or stiffness in the affected joint

Post-Procedure Care

After arthrocentesis, patients are typically advised to:

• Rest and avoid strenuous activities for a few hours
• Apply ice to reduce pain and swelling
• Elevate the affected joint above heart level to reduce swelling
• Monitor the needle site for signs of infection, such as redness, swelling, or increased pain