Joint Aspiration (Arthrocentesis)

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

Knee Bursitis Treatment

Joint Aspiration (Arthrocentesis)

The treatment of any bursitis dependson whether or not it involves infection. Aseptic prepatellar bursitis can be treated with ice compresses, rest, and anti-inflammatory and pain medications. Occasionally, it requires aspiration of the bursa fluid. This procedure involves removal of the fluid with a needle and syringe under sterile conditions and can be performed in the doctor's office. Sometimes the fluid is sent to the laboratory for further analysis. Noninfectious knee bursitis can also be treated with an injection of cortisone medication into the swollen bursa. Cortisone injections are sometimes done at the same time as the aspiration procedure.

What is a joint aspiration (arthrocentesis)?

A joint aspiration is a procedure whereby a sterile needle and syringe are used to drain synovial fluid from a patient's joint. Joint aspiration is typically performed by a doctor or ancillary health care provider as an office procedure or at the bedside of hospitalized patients. Joint aspiration is sometimes called joint drainage and is medically referred to as arthrocentesis.

How do patients prepare for a joint aspiration (arthrocentesis), and does it cause pain?

Patients do not need any special preparation before a joint aspiration. The aspiration is easily performed in a doctor's office as an outpatient procedure. Pain is minimized by topical or local anesthetics applied onto the patient's skin or just beneath the skin. Usually, there is a momentary, slight amount of pain as the needle is inserted into the patient's joint space. Withdrawal of the fluid into the syringe does not typically cause pain. Injection of medication into the joint does not typically cause pain. There is very slight pain sometimes as the needle is withdrawn from the joint. Any pain is reduced by topical or local anesthetics that block pain sensation.

What is the purpose of joint aspiration (arthrocentesis), and when is it performed?

Joint aspiration can be both used for diagnosis and medical treatment of arthritis of a joint. Joint aspiration is used to obtain fluid from the patient's joint for examination in the laboratory. Analysis of joint fluid can help the physician to define causes of joint swelling (joint effusion) or arthritis, such as infection, gout arthritis, and rheumatoid disease. Fluid from the joint can be tested for white cell count, crystals, protein, glucose, as well as cultured to detect infection. Each of these laboratory parameters can be helpful in defining the cause of a particular form of arthritis, particularly in distinguishing inflammatory from non-inflammatory forms of arthritis. The result can be key to identifying various potential rheumatology diseases and musculoskeletal conditions.

Joint aspiration can also be a helpful treatment in relieving joint swelling and pain. Removal of synovial fluid from the joint that is inflamed can also remove the white blood cells within that are sources of enzymes that can be destructive to the joint. This treatment can more rapidly restore the health of the joint. Bursa aspiration procedure and indications for bursitis are analogous to joint aspiration for arthritis, except the bursa is the target instead of the joint (intra-articular). The result and analysis of the fluid (aspirate) is similarly evaluated for various diseases and conditions in the laboratory.

Medically Reviewed by a Doctor on 2/2/2017

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