Joint Aspiration: Indications and Complication

Joint aspiration is a diagnostic and therapeutic procedure used for removal of fluid around or inside a joint with the help of a syringe and needle. The process of aspiration can be guided with the help of ultrasonography or fluoroscopy. When used as a diagnostic procedure the fluid is sent to a lab for further investigations like examination under a bipolar microscope for crystals, cell count, and bacterial culture.

Procedure of Joint aspiration

Joint aspiration can be performed on an out patient basis. On reaching the hospital you will be asked to change into a hospital gown and rest on an immobile surface. Your provider will then inject local anaesthesia over the skin of the joint. After the effect of anaesthesia set in, a needle will be introduced into your joint via a numbed skin and the fluid will be aspirated. When done for therapeutic purposes, medication is introduced after the aspiration to provide relief from the symptoms. On completion of the process the needle is withdrawn and a sterile dressing is applied at the site of entry of the needle.

Indications for joint aspiration

The indications for therapeutic joint aspiration are:

• Hemarthrosis-to prevent adhesions
• Septic joints-to prevent damage to joint and provide relief from discomfort
• Prior to injection of medicine into the joint-to increase efficacy
• Bursitis

Diagnostic joint aspiration is indicated for the diagnosis of:

• Gout
• Joint infection
• Prosthetic joint infection

Analysing the fluid from the joint is helpful in differentiating between inflammatory and non inflammatory arthritis.

Preparation for joint aspiration

Joint aspiration is indicated for a variety of conditions. On a visit prior to the procedure your provider would like to record a detailed history of your symptoms and perform a thorough medical examination. Inform your provider about all the medications that you have been consuming, you might be advised to stop taking the blood thinning medications few days before the procedure. Your provider would also like to know if you have a history of allergy to any medication, anaesthetic agent or latex.

Complications of joint aspiration

Joint aspiration is a safe procedure with low rates of complications. The complications encountered may be:

• Pain,
• Bruising,
• Swelling,
• Infection,

at the site of aspiration.

Recovery from joint aspiration

You will be allowed to go home soon after the procedure. In case you experience pain, it is advisable to obtain a prescription for pain medications from your provider, as some of the over-the-counter pain killers increase your risk of bleeding, hence hindering the healing.

Contact your provider immediately if you experience:

• Increase pain at the aspiration site which doesn’t improve on medication
• Redness, swelling and discharge from the aspiration site
• Fever .

Sources

• Knee Joint Aspiration and Injection-THOMAS J. ZUBER, M.D., Saginaw Cooperative Hospital, Saginaw, Michigan; Am Fam Physician. 2002 Oct 15;66(8):1497-1501.