What is wrist arthrocentesis?
Wrist arthrocentesis is a procedure to remove or aspirate fluid from the wrist joint through a needle for diagnostic and treatment purposes.
Why is wrist arthrocentesis performed?
Wrist arthrocentesis is performed in patients in the below conditions:
When is wrist arthrocentesis not performed?
Wrist arthrocentesis is not performed when a patient has
- Cellulitis (infection on the skin).
- Dermatitis or psoriasis (lesions on the skin).
- A history of bacteremia (severe bacterial infection).
- Bleeding disorders.
- Unstable joint or fracture.
How is wrist arthrocentesis performed?
Wrist arthrocentesis is usually done under local anesthesia, and the procedure is completed in less than 45 minutes.
- The area of the wrist is cleaned with betadine.
- Lidocaine is injected first on the skin and then into the deeper tissues.
- Once anesthesia is given, patient vitals are monitored.
- The patient is usually kept in a normal sleeping position with their palms open and flexed.
- Usually, the needle is inserted through the upper side of the wrist just away from the radial bone.
- The needle is usually inserted perpendicular to the skin.
- If the needle is touching the bone, the needle is pulled back, and it may be redirected slightly toward the thumb.
- Sometimes, the surgeon may also use the ulnar bone side approach. Keeping the wrist in the same relaxed position, the joint space can be identified by palpating just away from the ulnar joint.
- A 22-gauge needle is usually used for the procedure.
- The surgeon may also use bedside ultrasonography for joint aspiration to localize the optimal site for needle placement.
- A pop or give way is felt as the needle enters the joint.
- Sufficient fluid and any infection are aspirated through the needle.
- If the fluid cannot be withdrawn, rotating the needle, withdrawing it slightly or even reinjecting a little of the fluid often unclog the needle and allow additional fluid to be withdrawn.
- After the procedure is done and the sample is taken, the needle is withdrawn.
- In therapeutic cases where injections are to be given, the only syringe is removed, keeping the needle secure in the place, and the desired medication is injected.
- At the end of the injection procedure, the needle should be swiftly withdrawn, and light pressure should be applied on the needle site on the skin.
What are the risks involved in wrist arthrocentesis?
The risks involved in wrist arthrocentesis include the following:
Health Solutions From Our Sponsors
Medscape Medical Reference
Top Why Is Wrist Arthrocentesis Performed 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, lupus, gout, and pseudogout.
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.
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.
Osteoarthritis (OA)Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Also known as degenerative arthritis, osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
OA of the Knee ExercisesLearn about osteoarthritis and exercises that relieve knee osteoarthritis pain, stiffness and strengthen the knee joint and surrounding muscles through this picture slideshow.
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 ArthritisPsoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms and signs include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves anti-inflammatory medications and exercise.
Psoriatic Arthritis PicturePsoriatic arthritis is a specific condition in which a person has both psoriasis and arthritis. See a picture of Psoriatic Arthritis and learn more about the health topic.
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. 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. The 16 characteristic early RA signs and symptoms include the following.
- Both sides of the body affected (symmetric)
- Joint deformity
- Joint pain
- Joint redness
- Joint stiffness
- Joint swelling
- Joint tenderness
- Joint warmth
- Loss of joint function
- Loss of joint range of motion
- Many joints affected (polyarthritis)
16 Early Rheumatoid Arthritis (RA) Symptoms and SignsEarly 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 Friendly ExercisesRegular exercise boosts fitness and helps reverse joint stiffness for people with rheumatoid arthritis (RA). Our experts offer helpful exercises to get you started.
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.
Rheumatoid Arthritis vs. Lupus: Differences and SimilaritiesRheumatoid arthritis (RA) and lupus are two varieties of autoimmune diseases that cause flare-ups. While RA attacks the immune system on the joints, lupus involves many other parts of the body besides the joints. Common RA symptoms involve warm, swollen, and painful joints; morning stiffness in the joints or stiffness after inactivity, joint deformity, fever, fatigue, etc. Lupus symptoms include Malar rash (butterfly-shaped rash involving the cheeks and bridge of the nose), fever, joint pain in the absence of joint deformity, etc.
Steroids: for the Treatment of ArthritisSteroids decrease inflammation and may be used to treat many inflammatory conditions and diseases, such as systemic vasculitis, rheumatoid arthritis, lupus, and Sjögren's syndrome. Steroids are injected, rather than administered orally, to deliver a high dose of medication to a specific area. Side effects of steroid injections include infection, tendon rupture, skin discoloration, allergic reaction, and weakening of bone, ligaments, and tendons.
What Is the Treatment for Septic Arthritis?Surgical drainage of the septic joint is the treatment for septic arthritis. Drainage method includes removing infectious discharge via needle aspiration, tidal irrigation (repeated distention and irrigation of the joint with saline under local anesthesia through a needle), arthroscopy, and arthrotomy (creating an opening in the joint that is used for drainage).