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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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