Arthrocentesis

Overview

Arthrocentesis (Joint aspiration) is a procedure used to remove extra fluid from the space around a joint using a needle and syringe, it is commonly done on joints such the knee, ankle, elbow, or hip. 

The procedure will benefit the healthcare provider and helps them identify the underlying cause of painful and swollen joints. Additionally, it can provide relief from the condition’s symptoms. 

A tiny needle is used by a healthcare provider to aspirate fluid from the painful joint. After that, they might inject the joint with medications, such as corticosteroids. These medicines lessen pain and inflammation temporarily. During the procedures, a local anesthetic is typically used.

Reason for undergoing the procedure

The healthcare provider might perform joint aspiration to properly diagnose and assist in the treatment of joint–related issues or disorders.

The healthcare provider can identify various conditions that lead to joint pain. These include:

• Arthritis, which includes osteoarthritis, gout, and psoriatic arthritis.
• Autoimmune disorders such as rheumatoid arthritis and lupus.
• Bacterial infections, which may involve conditions like Lyme disease.
• Bursitis and tendonitis.

Joint aspiration can be performed to extract a substantial accumulation of fluid surrounding a joint. Draining the fluid helps reduce pressure, alleviate pain, and enhance the joint’s range of motion. Sometimes, after the fluid has been removed, a medication may be administered to help treat tendonitis or bursitis.

Risks

Joint aspirations and injections are generally considered safe procedures. In rare instances, complications can arise such as:

• Allergic reaction: An allergic reaction to the anesthesia or the injectable medicine is possible in certain people. This could, in rare circumstances, result in anaphylaxis, a severe and potentially fatal reaction.
• Infection: Infections in rare cases might spread after receiving steroid injections.
• Post–injection flare: A post–injection flare is thought to occur in 1 in 50 persons few hours after receiving an injection. Joint pain and swelling are brought on by it, but they subside after a few days.

Procedure

Joint aspiration is an effective treatment for both joint pressure and swelling. This results in less pain and better mobility following the treatment. It’s important to note that the extra fluid can occasionally come back. It’s possible that in the future, another joint aspiration will be necessary. 

Before the procedure

The healthcare provider will provide an explanation of the procedure and give the individual an opportunity to ask any questions they may have. The individual will be asked to sign a consent form, granting permission for the procedure. It’s advised to carefully review the form and seek clarification if any uncertainties arise.

The patient should let their healthcare provider know if they have any sensitivities or allergies to medications, latex, tape, or anesthetics. Additionally, all current medications, including prescription, over–the–counter, and herbal supplements, should be disclosed. It is crucial to let the healthcare provider know whether there is a history of bleeding issues or the use of anticoagulant medications, aspirin, or medications that impact blood clots. Before the procedure, these medications may need to be changed. 

It is advisable to let the healthcare provider know if they are pregnant or suspected to be pregnant. In most cases, preparations like fasting or sedation are not required. However, a healthcare provider could suggest certain preparations suited to the patient’s circumstance depending on their medical condition. 

During the procedure

Joint aspirations and injections are commonly conducted as outpatient procedures. In certain instances, healthcare providers might employ images from ultrasound or X–rays (fluoroscopy) to aid in guiding the processes.

The healthcare provider first sterilizes the skin. They may apply a numbing cream to the skin for small joints. In order to numb larger joint areas, such as the hips or shoulders, a local anesthetic may be required.

The healthcare provider may perform the following during the joint aspiration and injection.

• Places and inserts a thin needle into the joint.
• Connects an empty syringe to the needle, extracting fluid from the joint through aspiration. To extract all the fluid, it could occasionally take several syringes.
• Changes the syringe that contains the extra fluid for one that contains medication.
• Administers medication into the joint using the same needle and entry point.
• Removes the needle and finishes by covering the treated area with a bandage.
• The gathered fluid sample will be sent to the laboratory for examination.

After the procedure

There could be extra specifications depending on the particular area being treated:

• For 48 hours, avoid from moving heavy objects or exerting pressure to the treated area.
• Consider using nonsteroidal anti–inflammatory drugs (NSAIDs) to alleviate any discomfort.
• The healthcare provider might request feedback regarding both the immediate and lasting impacts of the procedure, potentially aiding in the diagnostic process.

Outcome

The area where the joint aspiration was performed may feel tender or sore for a few days after the treatment. It is advised to utilize a pain reliever as prescribed by the healthcare provider if the patient encounter any discomfort. Remember that certain painkillers or medications like aspirin may increase the risk of bleeding. Patient had been advised not to take any medications unless they have been prescribed by the healthcare provider.

It is advisable to contact the healthcare provider if the patient experience the following:

• Possible allergic responses, such as exacerbated pain or trouble breathing.
• Presence of a fever along with chills.
• Signs of infection, such as swelling, warmth, or redness in the treated site.
• Increase in pain at the treatment site.