Arthrocentesis

Chapter 50 Arthrocentesis



Common indications


Arthrocentesis allows the sampling or removal of joint fluid and can provide relief to persistent painful effusions. In chronic, degenerative effusions of the knee, a steroid injection can be performed after the aspiration of the joint effusion to relieve pain (Figure 50-1).


image

FIGURE 50-1 Anatomy.



Equipment


The equipment needed for arthrocentesis consists of a large aspiration syringe, lidocaine for anesthetizing the aspiration needle tract, and 0.5% bupivacaine for intra-articular injection if a steroid injection is planned. A 11/2 in., 18-gauge needle and a 11/2 in., 27-gauge needle are used in combination to draw up and to inject the anesthetic. Two 3-cc syringes are used, one for the block and one for the steroid injection. A sterile preparation and field must be maintained for this procedure (Figure 50-2).


image

FIGURE 50-2 Equipment.



Key steps



1. Preparation: Place the patient in the supine position and with the knee placed in 20° of flexion. Place a towel roll under the knee to support it in flexion. Cleanse the skin with antiseptic solution. Identify the patella and the effusion size by palpation. When aspirating effusions, the ideal location to enter the synovial sac is in the upper outer quadrant of the knee-joint space (Figure 50-3).

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Related posts:

  1. Excisional Biopsy
  2. Vacuum-Assisted Delivery
  3. Cervical Polypectomy
  4. Lumbar Puncture

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Dec 12, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Arthrocentesis

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