MedClinic > Blog > Traumatology > The puncture arthrocentesis of the joint


Joint puncture is a diagnostic and therapeutic procedure carried out in order to study the state of fluid contents of the joint. Joint puncture is performed according to the following indications:

  • determination of the nature of the liquid contents – exudate;
  • diagnosis of the state of menisci after their damage;
  • with the need to remove excessive amounts of exudate;
  • for introduction of antibiotics directly into the joint cavity;
  • for introduction of painkillers before reduction of dislocation;
  • for removal of air from the joint before the destruction of adhesive processes.

How is a joint puncture performed?

Joint puncture – arthrocentesis, is carried out using a large long needle, which is inserted into the joint cavity. Before the procedure, the injection site is thoroughly disinfected with an alcohol solution and iodine. When performing a puncture, the doctor very carefully and slowly inserts the needle, since with any sudden movement there is a risk of damage to the joint bursa. A 20-gram syringe is used for fluid from the joint bag. The length of the needle is 6 cm.

Puncture of the shoulder joint is carried out from different sides – from the sides, back and front, depending on which part of the joint needs to be examined. If puncture will be performed in the back, the patient is placed on a couch, in case of a puncture from the side of the joint, the patient lies on his side. The needle passes through the deltoid muscle.

Puncture of the elbow joint is carried out in its outer and rear parts if it is possible to bend arm in the elbow joint, this greatly facilitates the task of the doctor. Ankle puncture – the needle is inserted into the inside of the ankle, or in its front side. During the procedure, the patient is placed on his back, and his foot is slightly bent.

The simplest to perform is puncture of the knee joint. It is carried out in supine position, the leg is slightly bent in the knee if a person cannot do this because of severe damage to the joint, while there is a sharp pain, and a roller is placed under the knee.

With arthrocentesis of the knee, the needle is inserted no deeper than 3-4 cm.

Hip puncture: the patient is lying on his back; this is one of the most difficult procedures since the needle must be inserted with extreme caution so as not to pierce femoral artery, puncture of which threatens the start of severe internal bleeding. The cost of a joint puncture varies depending on in which clinic is it performed and which joint needs to be diagnosed.

Possible complications

Joint puncture is a complicated procedure and, despite the high qualification of a doctor, there are always risks of complications during it. Despite this, joint puncture is the most informative procedure, which gives an accurate picture of the condition of joints in injuries and degenerative processes.

What complications can arise after a puncture?

In case of inaccurate work of a doctor, infection may occur. To minimize this risk, the needle is not advanced with fingers, but with the help of medical tweezers. During puncture of a joint, synovial membrane may rupture. If injection of oxygen through the needle into the joint is necessary, embolism may develop.

Complications after a puncture are not always associated with low qualification of a doctor or his careless work while inserting the needle. In most cases, side effects of puncture are provoked by the fact that there is a complete synovial septum in joint or hypertrophic folds in the membrane or due to large fat accumulation. To minimize the risks after a joint puncture, you must follow all doctor’s recommendations.