Evacuation of abnormal collections of fluid from the joint space for synovial fluid analysis

    Septic arthritis

    Crystal arthropathy

    Hemarthrosis

    Inflammatory process

 Diagnose occult fracture or ligamentous injury

 Decrease/relieve pressure in the joint to provide pain relief

 Inject methylene blue and test for joint capsule integrity when overlying laceration potentially extends into joint space

 Instill medication for treatment and pain relief

CONTRAINDICATIONS

 Absolute Contraindications

    Abscess/cellulitis in the tissues overlying the site to be punctured (often infectious arthritis can mimic an overlying soft-tissue infection)

 Relative Contraindications

    Bleeding diatheses or anticoagulant therapy

    Prosthetic joint

    Known bacteremia

RISKS/CONSENT ISSUES

 Potential for introducing infection (sterile technique must be utilized)

 Pain and discomfort (local anesthesia will be given)

 Needle puncture can cause localized bleeding

 Reaccumulation of fluid may occur

 Risk of injuring articular cartilage with needle tip

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