Arthrocentesis: shoulder
Revision as of 18:15, 29 October 2019 by Rossdonaldson1 (talk | contribs)
Overview
Indications
General arthrocentesis indications
- Suspicion of septic arthritis
- Suspicion of crystal induced arthritis
- Evaluation of therapeutic response for septic arthritis
- Unexplained arthritis with synovial effusion
- Evaluation of joint capsule integrity if overlying laceration
- Relative: therapeutic (decrease intra-articular pressure, injection of anesthetics/steroids)
Contraindications
General arthrocentesis contraindications
- No absolute contraindications for diagnostic arthrocentesis
- Do not inject steroids into a joint that you suspect is already infected
- Relative Contraindications:
- Overlying cellulitis
- Coagulopathy
- Joint prosthesis (refer to ortho)
Equipment Needed
General arthrocentesis equipment
- Betadine or Chlorhexadine
- Sterile gloves/drape
- Sterile gauze
- Lidocaine
- Syringes
- Small syringe (6-12cc) for injection of local anesthetic
- Large syringe (one 60cc or two 30cc) for aspiration
- Needles
- 18 gauge: knee
- 20 gauge: most other joints
- 25 gauge: MTP joints
- 27 gauge for anesthetic injection
- Collection tubes (red top and purple for crystal analysis)
- Culture bottles
- Consider utilizing U/S to assess for effusion