How is joint aspiration (arthrocentesis) performed?

Updated: Mar 23, 2020
  • Author: Steven N Berney, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Recommended needle gauge and length are discussed elsewhere (see Equipment). A larger needle size may be selected if a large effusion is noted or if purulent fluid or hemarthrosis is known or suspected. After aspiration, the patient should not immediately stand up but should rest for a few minutes to prevent unsteadiness.

Sometimes, no fluid or only a small amount of fluid enters the syringe. This may be because the needle is not in the joint capsule, because the fluid is too thick for the needle’s gauge, or because the needle is clogged with debris. In this situation, consider withdrawing and repositioning the needle or using a larger needle. Maintain moderate suction.

If the first syringe fills and fluid is still in the joint, switch to a fresh syringe without removing the needle from the joint. The hub of the needle can be firmly gripped with a hemostat, and then the filled syringe can be twisted off and a new one screwed on without disturbing the needle's position.

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