https://idwiki.org/index.php?action=history&feed=atom&title=Arthrocentesis_of_the_kneeArthrocentesis of the knee - Revision history2026-05-19T09:11:15ZRevision history for this page on the wikiMediaWiki 1.43.8https://idwiki.org/index.php?title=Arthrocentesis_of_the_knee&diff=4095&oldid=prevMaintenance script: Imported from text file2020-07-04T01:17:23Z<p>Imported from text file</p>
<p><b>New page</b></p><div>== Indications ==<br />
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* Diagnostic: suspected septic arthritis, gout, or hemarthrosis<br />
* Therapeutic: relieve pressure from effusion, remove inflammatory or infected fluid, or steroid injections<br />
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== Contraindications ==<br />
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* Overlying cellulitis (but can be difficult to distinguish from gout)<br />
* Uncontrolled coagulopathy<br />
** INR &gt; 4<br />
** Platelets &lt;30<br />
* Prosthetic joint: call Orthopedices<br />
* Relatively, suspected bacteremia<br />
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== Risks ==<br />
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* Bleeding<br />
* Infection<br />
* Pain<br />
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== Materials ==<br />
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* Gauze, tape, gloves, alcohol wipes<br />
* 25G needle on 5cc syringe for local anaesthetic<br />
* 18-21G needle on 10cc syringe for aspiration<br />
* Lidocaine (1% or 2%)<br />
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== Procedure ==<br />
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* Positioning<br />
** Supine with knee extended or flexed at 15-20ยบ angle, using a rolled towel under the knee<br />
* Landmarking<br />
** Locate the parapatellar groove medially (or laterally) halfway between the top and bottom of the patella and about 1cm posterior<br />
* Clean the skin<br />
* Inject local anaesthetic, bleb then all the way to the joint<br />
* Insert needle for aspiration perpendicular to ground until you get into the joint space, then aspirate<br />
** If you hit bone, withdraw a bit and try again<br />
** If fluid stops flowing, can try to milk the joint<br />
* Send synovial fluid for:<br />
** Gram stain and culture (sterile urine container)<br />
** CBC (purple-topped CBC tube)<br />
** Microscopy for crystal<br />
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== Resources ==<br />
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* [https://www.nejm.org/doi/full/10.1056/NEJMvcm051914 NEJM Videos in Clinical Medicine: Arthrocentesis of the Knee]<br />
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[[Category:Rheumatology]]<br />
[[Category:Procedures]]</div>Maintenance script