Knee Aspiration

Last Updated on by FRCEM Intermediate

Indications

  • Diagnostic
    • Unexplained joint effusion to differentiate septic from an inflammatory or bloody mono-arthritis.
    • Remove joint fluid for cytology, microbiology and biochemical testing.
  • Therapeutic
    • Remove excess fluid or blood from joint to provide symptomatic relief, increase mobility and decrease pain in large effusions, crystal-induced arthropathy or haemarthrosis.
    • Intra-articular steroid injections

Contraindications

  • Local skin cellulitis/infection
  • Acute fracture
  • Joint prosthesis
  • Uncontrolled bleeding diathesis
  • Anatomically inaccessible joints
  • Uncooperative patient

Landmark

  • Needle inserted horizontally at the medial or lateral margin of the patella to pass beneath patella.
  • 20—gauge needle used for most joints.

Complications

  • Improper needle placement,
  • Dry tap.
  • Potential damage to cartilage
  • Risk of introducing infection

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