What equipment is needed to perform wrist arthrocentesis?

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

Aspiration of the wrist does not require specialized equipment.

Sterile technique must be followed during the procedure. Some experienced operators do not use sterile gloves. In this case, a no-touch technique is employed, in which palpation and marking of the puncture site precede application of the antiseptic. After the initial marking, the area is not touched. If the no-touch technique is used, nonsterile gloves should still be worn to protect the operator. Relatively inexperienced operators should wear sterile gloves. 

A 20-gauge needle should be used. For septic arthritis, an 18-gauge needle may occasionally be required, if the fluid is too viscous to allow aspiration through a smaller needle.

A 5-mL syringe is usually the most appropriate size. A "reciprocating syringe" has been developed to improve procedural performance. Some randomized data suggest that these syringes have benefits when compared with conventional syringes for joint aspiration. [12]

Forceps may be useful for holding the needle when changing the syringe between aspiration of the joint and injection of medication into the synovial cavity.


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