What is ankle arthrocentesis?
Arthrocentesis (joint aspiration) is a diagnostic procedure where the body’s synovial joint lubrication fluid is drained using a sterile needle and syringe. Ankle arthrocentesis is an important procedure used for diagnosing arthritis and differential diagnosis of inflammatory and noninflammatory arthritis. 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. Any trained physician, physician’s assistant or nurse can perform the procedure.
When is ankle arthrocentesis done?
Ankle arthrocentesis is indicated for any patient with inflamed ankle joints or who does not have an established diagnosis. Inflamed joints are recognized by being red, warm, tender, swollen, and painful during movement. Ankle arthrocentesis is indicated for diagnosis of the following conditions:
- Monoarticular arthritis (inflammation of the joint)
- Septic arthritis (infection of the joint)
- Joint effusion (swelling due to fluid accumulation in the body)
- Intra-articular fracture (fractures which involve the joint space)
- Crystal arthropathy (accumulation of calcium crystals in the joint and surrounding areas)
Joint aspiration may be performed as a treatment in certain conditions, such as:
- Septic joint or hemarthrosis (bleeding into the joints): Repeated aspirations are performed to relieve discomfort and prevent joint damage.
- Hemarthrosis (blood in the joints): Aspiration is performed to prevent adhesions.
When should ankle arthrocentesis be avoided?
Ankle arthrocentesis should be performed with caution in patients with a bleeding disorder or those on anticoagulant drugs (blood thinners). Patients taking anticoagulant drugs may be advised to pause the medications from a few days before to a few after the procedure.
How is ankle arthrocentesis performed?
- Ankle arthrocentesis is a relatively quick procedure and only in some cases may be performed under local anesthesia to avoid pain.
- A sterile needle of appropriate size and length is introduced into the joint and the synovial fluid is collected in syringes.
- The fluid collected is then analyzed microscopically.
- Apart from microscopic analysis, the appearance of the aspirated synovial fluid can indicate certain features.
- Normal fluid is clear or light yellow and viscous.
- Inflammatory fluid appears darker yellow to cloudy and loses its viscosity.
- Purulent fluid (pus in the fluid) is brownish to whitish and opaque.
- Occasionally, ankle arthrocentesis can be performed using radiological imaging, as it may be required to confirm the presence of fluid before aspirating.
- Radiological imaging can help aspirate other deep and technically difficult joints like the hip joint or spine.
After the procedure
- After the procedure, the patient is asked to rest for a few minutes, after that they can resume normal activities.
- Some patients may experience pain and bruise which resolves in a few days.
- Ice packs and pain killers can help reduce pain and bruising.
What are the complications of ankle arthrocentesis?
Ankle arthrocentesis is a relatively safe procedure, and complications are rare. The common complications patients usually face are localized bleeding, pain and swelling and sometimes reaction to local anesthesia. In rare cases, infection of the joint may occur, which is called septic arthritis.
If medications like steroids are simultaneously injected during the procedure, it may rarely cause localized shrinkage or hypopigmentation of the skin. Long-term use of steroid injections may cause systemic side effects like weight gain, puffy face, stretch marks and easy bruising.
Top What Is Ankle Arthrocentesis Related Articles
Arthritis (Joint Inflammation)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, and gout.
Arthritis: 16 Bad Habits That Cause Joint PainBeing overweight, wearing uncomfortable shoes, or carrying a heavy purse can make joint pain and arthritis symptoms worse. Some bad habits increase inflammation and put you at risk of osteoarthritis and rheumatoid arthritis. Protect joints and muscles and prevent swelling and joint disorders by eliminating these joint problem bad habits.
Physical and Occupational Therapy for ArthritisPhysical therapy can help a patient with arthritis to work out stiffness without damaging their joints. Occupational therapy teaches the patient how to reduce joint strain during daily activities. Those receiving occupational or physical therapy will learn about their arthritis, be given a dietary plan if they are overweight, get foot care advice, and learn methods of relieving discomfort.
Fungal ArthritisFungal arthritis is inflammation of a joint by a fungus that has invaded the body and is growing in the normally sterile joint. Fungal arthritis symptoms and signs include pain, redness, loss of range of motion, and swelling. Fungal arthritis treatment includes antibiotics, adequate drainage of the joint, and sometimes surgery.
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.
Hip BursitisBursitis of the hip results when the fluid-filled sac (bursa) near the hip becomes inflamed due to localized soft tissue trauma or strain. Symptoms include stiffness and pain around the hip joint. If the hip bursa is not infected, hip bursitis can be treated with ice compresses, rest, and anti-inflammatory and pain medications.
Osteoarthritis (OA or Degenerative Arthritis)Osteoarthritis, or degenerative arthritis, is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
OA & Your JointsDealing with joint pain and arthritis? Learn why weight matters--and why NOT to stretch before exercise. See these solutions for joint pain and tips to protect your joints from damage.
Osteoarthritis SlideshowOsteoarthritis (OA) is a degenerative joint disease most often affecting major joints such as knees, hands, back, or hips. Osteoarthritis symptoms include pain, swelling and joint inflammation.
Osteoarthritis QuizHow does osteoarthritis differ from other types of arthritis? Learn about osteoarthritis with this quiz.
Psoriatic Arthritis QuizHow is psoriatic arthritis related to psoriasis? Take this quiz to find out!
Rheumatoid Arthritis (RA)Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body.
16 Early Rheumatoid Arthritis (RA) Signs & SymptomsEarly rheumatoid arthritis (RA) symptoms and signs vary differently from person to person. The most common body parts that are initially affected by RA include the small joints of the hands, wrists, and feet, and the knees and hip joints. Joint inflammation causes stiffness. Warmth, redness, and pain may vary in degree.
RA SlideshowWhat is rheumatoid arthritis (RA)? Learn about treatment, diagnosis, and the symptoms of juvenile rheumatoid arthritis. Discover rheumatoid arthritis (RA) causes and the best medication for RA and JRA.
RA QuizHow is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid Arthritis (RA) Quiz to rest your RA IQ.
What Are the Benefits of Ankle Taping and Bracing?The concept of prophylactic (preventative) ankle wrapping was introduced more than 60 years ago to prevent or reduce the severity of ankle injuries. Tape or a brace may be applied before practice or a competition. Ankle bracing and taping should be done under the guidance of a sports medicine physician or a training athletic staff.
When Are Ankle Splints Used?Splints are primarily used to stabilize injuries to bones until the patient can be evaluated by a consultant, such as an orthopedic surgeon. Ankle splints are applied to minimize movement and provide support and comfort by stabilizing an injury at the ankle joint. Immobilizing the joint reduces pain and helps the injury heal faster.