What are the steps to perform shoulder arthrocentesis?

Updated: Dec 10, 2019
  • Author: Stephen Kishner, MD, MHA; Chief Editor: Erik D Schraga, MD  more...
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Answer

Steps in the performance of shoulder arthrocentesis are as follows:

  • Obtain informed consent
  • Palpate and mark the needle insertion site according to the approach chosen (see below)
  • Sterilize the skin surrounding the insertion site, and allow it to dry
  • Administer local anesthetic with a 25-gauge needle and a 3- or 5-mL syringe
  • Insert an 18-gauge needle, and aspirate on needle advancement into the joint space until synovial fluid is obtained
  • If injection is warranted, exchange the syringe for a corticosteroid-filled syringe and inject
  • Remove the needle, and apply pressure and a bandage
  • Divide the fluid among the specimen tubes

Needle placement accuracy rates appear to be significantly higher for the posterior approach to the glenohumeral joint than for the anterior approach. [8]


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