Sometimes, a shoulder arthrocentesis may be performed using radiological guidance because it may be required to confirm the presence of the fluid before aspirating. Radiological guidance can also be helpful in aspirating other deep and technically difficult joints such as the hip joint or spine.
A shoulder arthrocentesis is a relatively quick procedure but may be performed under local anesthesia to avoid pain. A needle of an appropriate size and length is introduced into the joints, and the synovial fluid is collected in syringes. The fluid is then sent for analysis under the microscope. Apart from the microscopic analysis, the appearance of the aspirated synovial fluid can indicate certain features. Normal fluid is clear or light yellow and is viscous. Inflammatory fluid appears darker yellow to cloudy in appearance and loses its viscosity. Purulent fluid (pus in the fluid) appears brownish to whitish and is opaque.
After the procedure, the patient would need to rest for a few minutes, soon after which they can resume normal activities. Patients may experience pain and bruising that resolves in a few days. Ice packs and painkillers can help reduce pain and bruising.
What is a shoulder arthrocentesis?
Joint aspiration (arthrocentesis) of the shoulder is a diagnostic procedure involving the extraction and analysis of the synovial fluid in the joints. It is an important component in diagnosing arthritis and differentiating an inflammatory arthritis from noninflammatory arthritis. An arthrocentesis can also be performed therapeutically (for pain relief, drainage of fluid, or injection of medications).
Any joint in the body can be aspirated. Joint aspiration is a relatively quick and inexpensive procedure to perform. It can be done in a clinic or hospital. It can be done by any physician, physician’s assistant or nurse who has the training and equipment.
When is a shoulder arthrocentesis done?
A shoulder arthrocentesis may be indicated for any patient with inflamed shoulder joints who does not have an established diagnosis. Inflamed joints are recognized by being red, warm, tender, swollen, and painful during movement. Some conditions that may require joint aspiration and analysis to establish diagnosis are as follows:
- Monoarticular arthritis (inflammation of the joints)
- Septic arthritis (infection of the joints)
- Joint effusion (swelling due to fluid accumulation in the body)
- Intra-articular fracture (fractures that involve the joint space)
- Crystal arthropathy (accumulation of calcium crystals in the joints and surrounding areas)
Joint aspiration may be performed as a treatment in certain conditions:
- Repeated aspirations can be part of the management of the septic joint to relieve discomfort and prevent joint damage.
- Aspiration can be considered in cases of hemarthrosis (blood in the joints) to prevent adhesions.
- Aspiration can be accompanied by injecting intra-articular medications such as corticosteroids or hyaluronic acid into the joints. Steroid injections reduce joint inflammation and pain and preserve joint structure and function. Hyaluronic acid lubricates the joints, decreases impact, delays joint aging, and reduces pain and stiffness.
When should a shoulder arthrocentesis not be done?
A shoulder arthrocentesis should be done with caution in patients with a bleeding disorder or those on anticoagulant drugs. Patients taking anticoagulant drugs may be advised to stop the medications few days before the procedure and resume after the procedure.
What are the complications of a shoulder arthrocentesis?
A shoulder arthrocentesis is a relatively safe procedure, and complications are rare. Common complications patients usually face are localized bleeding, pain and swelling and sometimes a reaction to local anesthesia. Infection of the joints may occur, which is called septic arthritis.
If other medications such as steroids are simultaneously injected, it may cause localized shrinkage or hypopigmentation of the skin. Long-term use of steroid injections may cause systemic side effects such as weight gain, poor bone health, puffy face, stretch marks, and easy bruising.
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Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
GoutBuildup of uric acid crystals in a joint causes gouty arthritis. Symptoms and signs include joint pain, swelling, heat, and redness, typically of a single joint. Gout may be treated with diet and lifestyle changes, as well as medication.
Gout Diet Foods MenuWhether you get gout can depend on your diet. Some foods like red meat, alcohol, and high-fructose corn syrup in sodas can raise your risks. But other foods can reduce gout attacks. Limiting foods that cause gout in your diet can protect you from this painful joint condition, a type of arthritis.
Gout PictureCondition characterized by 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. See a picture of Gout and learn more about the health topic.
Gout SlideshowGout attacks (gouty arthritis) are caused by crystals of uric acid deposits. Learn about symptoms, causes, treatments and medication for this painful condition.
Gout QuizLearn what causes those painful crystals to form during a gout flare. Take the Gout Quiz to learn all about this painful arthritic condition.
Joint Aspiration (Arthrocentesis)Joint aspiration (arthrocentesis) is a procedure where fluid is drained from a joint with a needle and syringe for laboratory analysis. This may help determine the causes of joint swelling or arthritis.
What Are Shoulder Muscles Called?Shoulder muscles are required for movements of the upper limb. They also give the shoulders their characteristic shape. The shoulder has multiple muscles. Shoulder muscles include the intrinsic muscles or scapulohumeral group, including the deltoid, teres major and four rotator cuff muscles. The extrinsic shoulder muscles are the trapezius, latissimus dorsi, levator scapula and rhomboids (rhomboid major and rhomboid minor).
What Is Joint Aspiration (Arthrocentesis)?Joint aspiration (arthrocentesis) is a diagnostic procedure that involves the extraction and analysis of the synovial fluid in the joints. It is an important procedure used for diagnosing arthritis and differentiating inflammatory arthritis from noninflammatory arthritis. Joint aspiration is a relatively quick procedure but may be performed under local anesthesia to avoid pain. Complications are rare.