Overview
How can the risk of injury from knee arthrocentesis be minimized?
What are the benefits of ultrasound-guided arthrocentesis?
What are the indications for diagnostic knee arthrocentesis?
What are the indications for therapeutic knee arthrocentesis?
What are the contraindications for knee arthrocentesis?
Periprocedural Care
What equipment is required to perform knee arthrocentesis?
When is procedural sedation and/or analgesia indicated for knee arthrocentesis?
How is local anesthesia administered for knee arthrocentesis?
How should the patient be positioned for knee arthrocentesis?
Technique
Why is knowledge of knee anatomy required to perform knee arthrocentesis?
What are the approach options for knee arthrocentesis?
What are the initial steps in knee arthrocentesis?
How is the parapatellar approach for knee arthrocentesis performed?
What is the suprapatellar approach for knee arthrocentesis performed?
How is the infrapatellar approach for knee arthrocentesis performed?
If a bone is encountered during needle insertion for knee arthrocentesis what steps should be taken?
What should be done if fluid stops flowing into the syringe while performing knee arthrocentesis?
What is the role of a hemostat in knee arthrocentesis?
What steps are taken following aspiration in knee arthrocentesis?
How are synovial fluid analysis results from knee arthrocentesis interpreted?
Which knee arthrocentesis results are characteristic of septic joint effusion?
Which factors can result in a dry tap when performing knee arthrocentesis?
How is potential injury avoided when performing knee arthrocentesis?
How are hemarthrosis caused by knee arthrocentesis treated?
How can the risk of infection be reduced when performing knee arthrocentesis?
When are antibiotics indicated in knee arthrocentesis?
Medications
What is the goal of drug treatment for knee arthrocentesis?
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Anterior view of right knee.
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Anatomic landmarks for knee arthrocentesis.
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Infiltration of local anesthetic via medial parapatellar approach (left knee).
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Left-knee aspiration via medial parapatellar approach.
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Application of bandage after left-knee aspiration.
Tables
|
Appearance |
WBCs, cells/µL |
PMN cells |
Glucose concentration, mg/dL |
Protein concentration, g/dL |
Normal |
Clear |
< 150 |
< 0.25 |
Serum glucose |
1.3-1.8 |
Noninflammatory |
Clear |
< 3000 |
< 0.25 |
Serum glucose |
2-3.5 |
Inflammatory |
Cloudy |
>3000 |
< 0.75 |
< 25 |
>4 |
Purulent |
Cloudy |
>50,000 |
>0.9 |
< 25 |
>4 |
Hemorrhagic |
Bloody |
>2000 |
~0.3 |
Serum glucose |
… |
PMN = polymorphonuclear; WBC = white blood cell. |
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