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.
A joint aspiration is a procedure whereby a
sterile needle and syringe are used to drain fluid from the
joint. Joint aspiration is typically performed as an office
procedure or at the bedside of hospitalized patients. Joint aspiration is medically referred to as arthrocentesis.
What is the purpose of joint aspiration?
Joint aspiration is used to obtain joint fluid for examination in
the laboratory. Analysis of joint fluid can help to define causes of
joint swelling or arthritis, such as
infection, gout, and rheumatoid
disease. Joint fluid 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.
Joint aspiration can also be helpful in relieving joint
swelling and pain. Removal of joint fluid that is inflamed can also
remove the white blood cells within that are sources of enzymes that
can be destructive to the joint. Occasionally, cortisone medications
are injected into the joint during the joint aspiration in order to rapidly
relieve joint inflammation and further reduce symptoms.
How is joint aspiration performed?
The skin over the joint is sterilized using a liquid, typically
iodine solution (Betadine). Local anesthetic is used in the area of
the joint; either by injection, topical liquid freezing, or both. A
needle with a syringe attached is inserted within the joint an fluid
is sucked back (aspirated) into the syringe. For certain conditions,
the doctor will also inject medication into the joint after fluid
removal. The needle is then removed and a Band-Aid or dressing is
applied over the entry point.
What are complications of joint aspiration?
Complications of joint aspiration are uncommon. Possible
complications include local bruising, minor bleeding into the joint,
and loss of pigment in the skin that was entered by the needle. A
rare but serious complication of joint aspiration is infection of
the joint (septic arthritis).
If cortisone-related medications (corticosteroids) are injected into
the joint, additional uncommon complications include inflammation in
the joint as a result of the medication crystallizing, shrinkage
(atrophy) or loss of pigment of skin at the injection site, increased
blood sugar (worsening of diabetes mellitus), and aggravation of
preexisting infection elsewhere in the body. If multiple injections
with corticosteroids are given too frequently, it is possible to
develop systemic side effects (side effects throughout the body),
such as weight gain, puffy face and trunk, and easy bruising.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Lyme disease is a bacterial illness, which is spread by ticks when they bite the skin. Initially the disease affects the skin causing a reddish rash associated with flu-like symptoms. It takes weeks to months after the initial redness of the skin for its effects to spread throughout the body. Lyme disease can be treated with antibiotics. Lyme disease can be prevented by using tick avoidance techniques.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Brucellosis is an infectious disease caused by the Brucella bacteria. Symptoms and signs include sweating, fever, fatigue, dizziness, headache, cough, chest, joint, and abdominal pain, and enlarged liver and/or spleen. Brucellosis is treated with antibiotics.
Plant thorn synovitis (plant thorn arthritis) is joint inflammation caused by a thorn puncturing the joint and leaving residual plant matter in the joint. Symptoms and signs include swelling, reddish discoloration, loss of range of motion, pain, tenderness, and stiffness. Treatment involves a surgical procedure called a synovectomy with joint lavage to remove the affected joint lining tissue and thorn fragments.
Hydroxyapatite crystal disease is the inflammation caused by hydroxyapatite crystals. These tiny crystals of hydroxyapatite deposit by mistake in or around joints and may cause inflammation of the joints and nearby tissues such as the tendons and ligaments (particularly causing rotator cuff problems in the shoulder). Treatment options include rest, cold application, medications to reduce inflammation, and cortisone-related medication injections.
Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where
two different bones meet. A joint functions to move the body parts connected by its bones.
Arthritis literally means inflammation of one or more joints.
Arthritis is frequently accompanied by joint pain. Joint pain is
referred to as arthralgia.
There are many types of arthritis (over 100 identified, and the number is growing). The types range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.
The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary facto...
Arthritis RSS
Healthy Living Tips
This site complies with the