Arthrocentesis (joint drainage) is an important diagnostic tool used in identifying a variety of issues with the joints. The procedure can also be used to alleviate pressure and swelling in joints that are inflamed. For individuals with ongoing pain, stiffness, immobility, swelling and other joint problems, arthrocentesis is often an important part of diagnosis and treatment.

How is Arthrocentesis Performed?

If you have ongoing joint swelling and discomfort, your doctor may recommend arthrocentesis to diagnose your joint condition and relieve pressure and swelling.

Arthrocentesis is an outpatient procedure1 that can be performed in a doctor’s office or medical clinic without pain medication. However, topical pain medications can be administered to patients who want it.

During the procedure, a sterile needle is inserted into the affected joint space by an orthopedic surgeon, sports medicine doctor or rheumatologist. Once the needle is properly placed, synovial fluid from the joint space is collected in a syringe. Withdrawal of this fluid does not typically cause pain. In fact, removal of fluid often reduces pressure and relieves joint pain.

Once an adequate amount of synovial fluid is collected, it is tested and evaluated for a number of issues, including color and thickness, as well as the presence of bacteria, proteins, chemicals and crystals.

Conditions Diagnosed with Arthrocentesis

The following conditions may be ruled out or confirmed with arthrocentesis:

  • Gout : Arthrocentesis can provide a definitive diagnosis of gout in people with swollen, painful, immobile big toe joints2
  • Pseudogout : Arthrocentesis provides a definitive diagnosis for pseudogout if CPP crystals are detected in the synovial fluid3
  • Rheumatoid arthritis : Synovial fluid in patients with rheumatoid arthritis4 may exhibit signs of inflammation and abnormal glucose levels, among other characteristics. Arthrocentesis is also important in helping doctors eliminate other diseases or conditions that can mimic rheumatoid arthritis.
  • Osteoarthritis : Arthrocentesis can help identify a number of indicators of osteoarthritis and can exclude gout, pseudogout and infection as the source of a patient’s joint pain
  • Septic Arthritis : Septic arthritis, the bacterial invasion of a joint’s synovial space, is diagnosed by collecting synovial fluid from the affected joint5. A positive bacterial culture indicates infectious arthritis and necessitates immediate treatment.

Conditions Treated with Arthrocentesis

Arthrocentesis is used for more than just the diagnosis of joint conditions or infection. It is commonly prescribed to treat painful joint swelling and pressure associated with osteoarthritis, rheumatoid arthritis, lupus, unexplained joint effusion, and joint injury. Occasionally, arthrocentesis may be recommended to remove fluid associated with bursitis. Arthrocentesis may also be recommended to patients who want to receive therapeutic joint injections but have excess fluid around the joint.

Arthrocentesis may not be a good diagnostic tool or treatment option for people who have coexisting infections in other parts of the body, have an open wound near the affected joint, or have a bleeding disorder.

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