Arthrocentesis
(Closed Joint Aspiration)
Definition |
Body Parts Involved |
Reasons for Procedure |
Complications |
What to Expect |
Outcome |
Call Doctor If
Definition
Puncture of a joint space with a sterile needle in order to do either of the following:
- Withdraw fluid for diagnosis and/or treatment of a condition
- Inject medications into the joint space
Parts of the Body Involved
Any joint in the body
Reasons for Procedure
- Diagnose and/or treat a painful, swollen, fluid-filled joint
- Diagnose the specific type of arthritis occurring within a joint
- Verify the presence of an infection, identify the causative agent, and follow the progress of antibiotic therapy
- Check for crystals in the joint fluid, which would be a sign of gout
- Inject medications into the joint space, such as an anesthetic or an anti-inflammatory agent, such as cortisone
Risk Factors for Complications during the Procedure
- Infections of adjacent skin or surrounding soft tissue
- Pre-existing bleeding disorder
- Use of blood thinners (anticoagulants), with poorly controlled blood levels
- Allergic reaction to local anesthetic
What to Expect
Prior to Procedure
Your doctor will likely do some or all of the following:
- Examine your joint
- X-ray
- CT scan – a type of x-ray that uses a computer to make pictures of the inside of the joint
- MRI scan – a test that uses magnetic waves to make pictures of the inside of the joint
During Procedure - Anesthesia, possibly (depending on the joint)
Anesthesia - Local, if any
Description of the Procedure - Your doctor will use an antiseptic solution to clean the area of the joint where the needle will be inserted. You may receive an injection of a local anesthetic to numb the area. The arthrocentesis needle is inserted into the fluid-filled space within the joint, called the joint cavity, and fluid is withdrawn into the syringe.
When a sufficient sample has been obtained for diagnosis, or when an appropriate amount of fluid has been drained, the needle is removed. Pressure is put on the area where the needle entered the joint, and a small bandage is placed over the puncture.
After Procedure – Laboratory examination of the fluid sample
How Long Will It Take? 5-10 minutes
Will It Hurt? If local anesthetic is given, there will be some stinging or burning during the injection. Without local anesthetic, there is some pain during insertion of the needle, and you may feel a popping sensation as the needle enters the joint space.
Possible Complications:
- Infection of the joint
- Bleeding into the joint
- Fluid may recur within the joint
Average Hospital Stay - None
Postoperative Care:
- You can go home soon after the procedure is completed
- You may be advised to ice the joint every 3-4 hours, for 20 minutes at a time, for the 24 hours following the procedure
- You may be advised to take acetaminophen, ibuprofen, or some other relatively mild pain killer for a day or two after the procedure
- Your doctor will tell you whether you may immediately resume normal activity or whether you should have some period of restricted activity
Outcome
If arthrocentesis is done as a diagnostic test, the laboratory report on the fluid may reveal the reason for your joint inflammation.
If arthrocentesis is done to drain accumulated fluid, your problem may completely resolve. However, depending on the reason for the fluid accumulation, you may have a recurrence.
If medications are injected into the joint, they may help to decrease inflammation and to numb pain within the joint. Over time, these effects will wear off and you may require further treatment.
Call Your Doctor If Any of the Following Occurs
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the site of the arthrocentesis
SOURCES:
Clinical Procedures in Emergency Medicine, 3rd ed. W.B. Saunders Co, 1998.
Emergency Medicine: Concepts and Clinical Practice, 4th ed. Mosby-Year Book, 1998.
Last reviewed February 2001 by Medical Review Board
