Arthrocentesis

Arthrocentesis is a procedure in which a needle is used to puncture a joint. If arthrocentesis is performed correctly and there is effusion in the joint, it may be possible to obtain the effusion for testing. Synovial fluid testing is the most accurate method for determining the cause of the effusion and is indicated in all cases where there is significant effusion in one or more joints and the cause is unclear.

Contraindications

The presence of infection and other skin rashes at the site of the proposed puncture is a contraindication to the procedure.

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Methodology of implementation

Arthrocentesis is performed under aseptic conditions. Before performing it, it is necessary to prepare a container for placing the sample. Local anesthesia is performed with lidocaine or difluoroethane spray. To exclude damage to the nerves, arteries and veins, which are usually located in the area of the flexor surfaces of the joints, the puncture of many joints is performed from the side of the opposite (extensor) surface. For the puncture of most joints, a 0.9 mm needle is used, through which the maximum possible amount of fluid is removed. There are a number of anatomical landmarks for the correct performance of the procedure.

The carpophalangeal, metatarsophalangeal and interphalangeal joints are punctured identically: a needle with a diameter of 0.8 or 0.7 mm is used; the puncture is performed from the dorsal surface on either side of the tendon.