Metatarsophalangeal Arthrocentesis Periprocedural Care

Updated: Feb 05, 2016
  • Author: Jefferson R Roberts, MD; Chief Editor: Erik D Schraga, MD  more...
  • Print
Periprocedural Care

Equipment

Equipment for metatarsophalangeal arthrocentesis includes the following:

  • Gloves (which need not be sterile as long as one does not touch the sterile site)
  • Gauze pad (4 × 4 in.)
  • Skin preparatory solution
  • Lidocaine 1%
  • Syringe for lidocaine, 5 mL
  • Needle for anesthetic, 27 gauge
  • Syringe for arthrocentesis, 10 or 20 mL
  • Needle for arthrocentesis, 21 gauge
  • Specimen tubes - Purple top for cell count and sterile tubes for Gram stain, culture, and crystal analysis
  • Adhesive bandage [3, 6]
  • Hemostat may be helpful
Next:

Patient Preparation

Anesthesia

Local anesthesia may be needed, depending on both the provider’s and patient’s preferences. [7] After consent is obtained and typical skin preparation performed, including identification of the needle insertion site, a 27-gauge needle is used to inject 1-2 mL of local anesthetic (eg, lidocaine 1%) into the subcutaneous tissue. [6]

An alternative to an injectable local anesthetic is a localized spray of topical anesthetic skin refrigerant (eg, ethyl chloride).

Positioning

The patient should be placed either in the sitting or the supine position with the foot supported. [3, 6]

Previous