JOINT ASPIRATION

Joint aspiration, otherwise known as arthrocentesis, is a procedure that involves the use of a needle to remove synovial fluid for analysis, reduce the tension within the joint capsule and to eliminate pain that is felt on the area.

This procedure is typically done on an outpatient basis or during a random clinic visit. It is a relatively safe procedure with very minimal side effects and negligible post-procedure discomfort. No scheduling is necessary except for those persons who have bleeding tendencies, previous history of allergic reactions or those patients who are taking anticoagulants which they need to discontinue for approximately once a week for older types of blood thinners and at least 24 hours for a newer generation of anticoagulants.

TYPES

  • Simple joint aspiration – The main goal of doing this procedure is to relieve the tension within the affected joint
  • Joint aspiration with synovial fluid testing- This is important to identify inflammatory from non-inflammatory causes of joint swelling
  • Joint aspiration with arthrography- utilizes a dye to visualize the entire structure of the joint involved. It is usually done to look for the cause of pain and discomfort in the affected area.

SYMPTOMS

Pain, swelling and limitation of motion are the most common presenting symptom of disease conditions that would need joint aspiration. 

Diseases that may need arthrocentesis so that an appropriate analysis of the synovial fluid can be done include gout, psoriatic arthritis, infectious arthritis and rheumatoid arthritis.

DIAGNOSIS

Before the performance of the arthrocentesis. Some ancillary procedures will be requested to confirm the diagnosis, and these include either of the following:

  • Imaging of the affected joint-  Shows swelling of the involved joints, narrowing of the joint space
  • Ultrasonography of the affected joint- this diagnostic procedure is of importance in guiding the practitioner during intraarticular injection of steroids.
  • Magnetic Resonance Imaging- this is a highly sophisticated machine that can give the clinician an early clue as to the type of joint inflammation that the patient has. Findings include pannus formation and thinning of the cartilage.

TREATMENT

After the procedure, one may expect to have any of the following: 

  • Pain on the injection site – This can be relieved by taking analgesics such as acetaminophen, ibuprofen or paracetamol or application of a pain reliever patch granted that it is placed away from the area of the puncture.
  • Redness over the site of puncture– Placing an ice pack over the affected area for the first 48 hours can help numb the area and reduce the redness
  • Presence of blood collection on the site of the procedure, otherwise known as a hematoma.

Of note, all of the above symptoms mentioned above are generally expected to happen post-procedure.

One should inform the medical practitioner for the presence of any of the following: 

  • Sudden onset of fever above 38 degrees Celsius
  • Inability to move or mobilize the area involved in the procedure
  • Pain on moving the body part involved in the procedure.

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