Joint aspiration and injection.
Joint aspiration/injection is an invaluable procedure for the diagnosis and treatment of joint disease. The knee is the commonest site to require aspiration although any non-axial joint is accessible for obtaining synovial fluid. Septic arthritis and crystal arthritis can be readily diagnosed by aspirating synovial fluid. Intra-articular injection of long-acting insoluble corticosteroids produces rapid resolution of inflammation in most injected joints and is a well established procedure in rheumatological practice. The technique involves only a knowledge of basic anatomy and should not be unduly painful for the patient. Provided sterile equipment and a sensible, aseptic approach are used it is a safe procedure. This chapter addresses the indications, technical principals, expected benefits and risks of intra-articular corticosteroid injection. The use of other intra-articular injections including osmic acid, radioisotopes and hyaluronic acid, which are less universally utilised than intra-articular corticosteroid, will also be addressed.
Courtney
Philip
P
Department of Rheumatology Clinical Sciences Building, Nottingham City Hospital, Nottingham, NG5 1PB, UK.
Doherty
Michael
M
D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007270:Injections, Intra-Articular / Q000379:methods*; D007592:Joint Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D007596:Joints / Q000473:pathology; D009993:Osmium Tetroxide / Q000008:administration & dosage; D013396:Suction / Q000379:methods*; D015021:Yttrium Radioisotopes
D005938:Glucocorticoids; D015021:Yttrium Radioisotopes; D006820:Hyaluronic Acid; D009993:Osmium Tetroxide