Joint aspiration

Joint aspiration

Joint aspiration

Synovial fluid analysis is a series of tests performed on synovial (joint) fluid to help diagnose and treat joint-related abnormalities. To obtain a synovial fluid sample, a needle is inserted into the knee between the joint space. When the needle is in place the synovial fluid is then withdrawn. The sample is sent to the lab for analysis.

Synovial fluid analysis

Synovial fluid analysis is a group of tests that examine your joint (synovial) fluid. The tests help diagnose and treat joint-related problems.

How the Test is Performed
A sample of synovial fluid is needed for this test. Synovial fluid is normally a thick, straw-colored liquid found in small amounts in joints, bursae (fluid-filled sacs in the joints), and tendon sheaths.

After the area is cleaned, the health care provider will insert a sterile needle through the skin and into the joint space. Once the needle is in the joint, fluid is drawn through it into a sterile syringe.

The fluid sample is sent to the laboratory. The laboratory technician will:

Check the sample’s color and clarity
Place it under a microscope, count the number of red and white blood cells, and then look for crystals (in the case of gout) or bacteria
Measure glucose, proteins, uric acid, and lactic dehydrogenase (LDH)
Culture the fluid to see if any bacteria grow
How to Prepare for the Test
Normally, no special preparation is needed. Tell your health care provider if you are taking blood thinners, because they can affect test results or your ability to take the test.

How the Test Will Feel
Sometimes, the health care provider will first inject numbing medicine into the skin with a small needle, which will sting. A larger needle will be used to draw out the joint fluid or synovial fluid.

This test may also cause some pain if the tip of the needle touches bone. The procedure usually lasts less than 1 to 2 minutes.

Why the Test is Performed
The test can help diagnose the cause of pain, redness, or swelling in joints.

Sometimes, removing the fluid can also help relieve joint pain.

This test may be used when your doctor suspects:

Bleeding in the joint after a joint injury
Gout and other types of arthritis
Infection in a joint
What Abnormal Results Mean
Abnormal joint fluid may look cloudy or abnormally thick.

Blood in the joint fluid may be a sign of injury inside the joint or a body-wide bleeding problem. An excess amount of normal synovial fluid can also be a sign of osteoarthritis.

Risks
Infection of the joint — unusual but more common with repeated aspirations
Bleeding into the joint space
Considerations
Ice or cold packs may be applied to the joint for 24 to 36 hours after the test to reduce the swelling and joint pain. Depending on the exact problem, you can probably resume your normal activities after the procedure. Talk to your health care provider to determine what activity is most appropriate for you.

Alternative Names
Joint fluid analysis; Joint fluid aspiration

Orthopedic services

Orthopedics, or orthopedic services, is the medical specialty that involves the treatment of the musculoskeletal system, which is made up of your body’s bones, joints, ligaments, tendons, and muscles.

Information
Any number of medical problems can affect the bones, joints, ligaments, tendons, and muscles.

Bone problems may include:

Bone deformities
Bone infections
Bone problems may include:
Bone tumors
Fractures
Need for amputation
Nonunions and malunions
Spinal deformities
Joint problems may include:

Arthritis
Bursitis
Dislocation
Joint pain
Joint swelling
Ligament tears
Common orthopedic-related diagnoses based on body part:

Ankle and foot:

Bunions
Fasciitis
Foot and ankle deformities
Fractures
Hammer toe
Heel pain
Heel spurs
Joint pain and arthritis
Sprains
Tarsal tunnel syndrome
Sesamoiditis
Hand and wrist

Fractures
Joint pain
Arthritis
Tendon or ligament injury
Carpal tunnel syndrome
Ganglion cyst
Rheumatoid arthritis
Tendinitis
Shoulder

Arthritis
Bursitis
Dislocation
Frozen shoulder (adhesive capsulitis)
Impingement syndrome
Loose or foreign bodies
Rotator cuff tear
Rotator cuff tendinitis
Separation
Torn labrum
SLAP tears
Knee:

Cartilage and meniscus injuries
Dislocation of the kneecap (patella)
Ligament sprains or tears (anterior cruciate, posterior cruciate, medial collateral and lateral collateral ligament tears)
Loose or foreign bodies
Osgood-Schlatter disease
Pain
Tendinitis
Elbow:

Arthritis
Bursitis
Dislocation or separation
Loose or foreign bodies
Pain
Tennis or golfers elbow (epicondylitis or tendinitis)
Elbow stiffness or contractures
Spine:

Herniated (slipped) disc
Infection of the spine
Injury to the spine
Scoliosis
Spinal stenosis
Spinal tumor
Fractures
Spinal cord injuries
SERVICES AND TREATMENTS

Imaging procedures can help diagnose or even treat many orthopedic conditions. Your doctor may order:

Arthrograms (joint x-ray)
Bone scans
Computed tomography (CT) scan
Discography
Magnetic resonance imaging (MRI) scan
X-rays
Sometimes, treatment involves injections of medicine into the painful area. This may involve:

Corticosteroid injections into joints, tendons and ligaments, and around the spine
Hyaluronic acid injection to help relieve arthritis pain
Surgical procedures used in the treatment of orthopedics include:

Amputation
Arthroscopic surgeries
Bunionectomy and hammer toe repair
Cartilage repair or resurfacing procedures
Cartilage surgery to knee
Fracture care
Joint replacement (arthroplasty)
Ligament reconstructions
Repair of torn ligaments and tendons
Spine surgery, including diskectomy, foraminotomy, laminectomy, and spinal fusion
Newer orthopedic services procedures include minimally invasive surgery techniques, advanced external fixation, and the use of bone graft substitutes and bone-fusing protein.

WHO IS INVOLVED

Orthopedic care often involves a team approach. Your team may include a doctor as well as a non-doctor specialist such as a physical therapist, as well as others.

Orthopedic surgeons receive 5 or more extra years of training in the care of disorders of the bones, muscles, tendons, ligaments.
Physical medicine and rehabilitation doctors have 4 or more extra years of training in this type of care after they graduated from medical school. They are also referred to as physiatrists. They do not perform surgery although they can give joint injections.
Sports medicine physicians are doctors with experience in sports medicine who have a primary specialty in family practice, internal medicine, emergency medicine, pediatrics, or physical medicine and rehabilitation. Most have 1-2 years of additional training in sports medicine through subspecialty programs in sports medicine. Sports medicine is a special branch of orthopedics designed to provide complete medical care to active people of all ages.
Other doctors that may be a part of the orthopedics team include:

Neurologists
Pain specialists
Primary care doctors
Psychiatrists
Non-doctor health professionals that may be a part of the orthopedics team include:

Athletic trainers
Counselors
Physical therapists
Psychologists
Social workers
Vocational workers

Arthroscopy

Arthroscopy is surgery that is done using a tiny camera on the end of a tube to check for and treat joint problems.

See also:

Knee arthroscopy
Rotator cuff repair
Shoulder arthroscopy
Description
This procedure is typically done on the knee, hip, ankle, shoulder, elbow, or wrist.

Three different types of anesthesia (pain management) may be used for arthroscopy surgery:

General anesthesia. You will be unconscious and unable to feel pain.
Painkilling medicine. Your joint may be numbed, and you may be given medicines that relax you. You will stay awake.
Spinal anesthesia. This is also called regional anesthesia. The painkilling medicine is injected into a space in your spine. You will be awake but will not be able to feel anything below your waist.
The area is cleaned and a pressure band (tourniquet) may be applied to restrict blood flow. The health care provider will then make a surgical cut into the joint. Sterile fluid is passed through the joint space to expand the joint and provide a better view.

Next, a tool called an arthroscope is inserted into the area. An arthroscope consists of a tiny tube, a lens, and a light source. It allows the surgeon to look for joint damage or disease.

Images of the inside of the joint are displayed on a monitor. One or two other surgical cuts may be needed so the doctor can use other instruments to remove bits of cartilage or bone, take a tissue biopsy, or perform other minor surgery. In addition, ligament repairs can be done using the arthroscope.

Why the Procedure is Performed
A number of different injuries and diseases may cause joint pain or problems.

Arthroscopy may be needed to:

Diagnose the cause of joint pain after an injury
Perform carpal tunnel surgery
Remove loose bone or cartilage fragments in the joint
Remove the lining of the joint. This lining is called the synovium, and it may become swollen or inflamed from arthritis.
Repair a torn ligament or tendon
Repair damaged cartilage or meniscus (the piece of cartilage that cushions the knee joint area)
Risks
The risks from surgery are:

Allergic reactions to medications
Breathing problems
Other risks from this surgery include:

Bleeding into the joint
Blood clot
Damage to the cartilage, meniscus, or ligaments in the knee
Infection in the joint
Injury to a blood vessel or nerve
Joint stiffness
Outlook (Prognosis)
After the procedure, the joint will probably be stiff and sore for a few days. Ice is commonly recommended after arthroscopy to help relieve swelling and pain.

You can resume gentle activities, such as walking, immediately. However, using the joint too much may cause swelling and pain, and may increase the chance of injury. Do not restart normal activity for several days or longer.

You may need to make arrangements for work and other responsibilities. Your doctor may also recommend physical therapy.

Depending on your diagnosis, you may have other resrictions or need to do certain exercises.

Before the Procedure
You will usually have an MRI scan of the joint done before surgery is planned.

Always tell yoru doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

You will be asked to stop taking drugs that make it harder for your blood to clot beginning 2 – 3 weeks before surgery. These drugs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Naprosyn, Aleve).

Ask your doctor which drugs you should still take on the day of your surgery.

You will usually be asked not to eat or drink anything for 6 – 12 hours before the procedure. Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

You must sign a consent form. Make arrangements for transportation from the hospital after the procedure.

Alternative Names
Arthroscopy – hip; Arthroscopy – wrist; Arthroscopy – ankle