What is the role of wrist arthrocentesis in the management of dorsal wrist tendon pathology?

Updated: Nov 03, 2020
  • Author: Richard S Krause, MD; Chief Editor: Erik D Schraga, MD  more...
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Answer

Inflammation and swelling of the extensor tendon sheaths over the dorsal wrist may be due to a number of inflammatory processes (most commonly RA but occasionally crystal-induced arthritis or infectious processes). The areas of swelling are often well defined and close to the surface, and they are easily entered with direct aspiration, usually at a 30-45º angle, with the needle directed along the course of the swollen tendon.

Fluid is often easily obtained. In some patients (those with RA, in particular), proliferative synovial tissue limits the amount of fluid that can be aspirated. After aspiration, the area can be injected with 0.5 mL of corticosteroid mixed with 0.5-1 mL of lidocaine, if indicated.


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