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.