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Arthrocentesis is a procedure that is performed to obtain synovial fluid from within a joint capsule, both for diagnostic and for therapeutic purposes. It is used in multiple disease processes, including arthritis, gout, and infectious processes such as septic arthritis. This activity outlines the use of arthrocentesis in clinical settings and highlights the role of the interprofessional team in evaluating and treating patients who undergo this procedure. Objectives: Identify the indications and contraindications of arthrocentesis. Describe the equipment, personnel, preparation, and technique required for arthrocentesis. Review the clinical significance of synovial fluid analysis findings after arthrocentesis. Outline interprofessional team strategies for improving care coordination and efficiency to advance arthrocentesis and improve outcomes. Access free multiple choice questions on this topic.

Arthrocentesis is a procedure performed to collect synovial fluid from joint spaces for the identification of a disease process or the relief of painful or bothersome symptoms. There are numerous indications for joint fluid aspiration, the most important of which includes the evaluation of synovial fluid for evidence of infection or inflammation. While the procedure specifics vary depending on the joint being aspirated, the general technique and steps remain consistent. The procedure tends to be very safe overall with few complications if performed correctly, and only a small number of contraindications exist.[1][2][3][4]

Complications with arthrocentesis are rare.[1][2] They include the following: Infection. If the procedure is not done with a completely aseptic technique, or if there is an overlying infection, skin bacteria may be introduced into the joint space. This can be limited by maintaining strict sterile technique and avoiding insertion through infected skin or subcutaneous tissue. Bleeding. Hemarthrosis after arthrocentesis is rare but more common in patients with a bleeding diathesis. When inserting the needle during the procedure, do so in a linear fashion without side-to-side movements to avoid shearing blood vessels and other structures. Allergic reaction. Patients with allergy to local anesthetic should not receive that class of medications.

All procedures done in clinical practice should be performed with an interprofessional team-based approach. Most commonly, arthrocentesis is performed by the physician in the emergency department, hospital, or outpatient setting, but other members of the interprofessional team play an integral role. This procedure does not commonly require procedural sedation, but in the extremely anxious patient, a provider may wish to perform sedation before the procedure is performed. In that situation, other members of the interprofessional team, including a nurse and a respiratory therapist, have important roles in monitoring the patient and documentation of the procedure. Other roles that nurses play regarding arthrocentesis include educating the patient and family about the procedure, preparing the patient and room, and assisting the physician during the procedure as needed to ensure optimal outcomes.[10]