View source for Arthrocentesis: knee

==Overview==
[[File:Knee diagram2.png|thumb|Anatomy of anterolateral aspect of right knee.]]

==Indications==
{{Arthrocentesis indications}}

==Contraindications==
{{Arthrocentesis contraindications}}

==Equipment Needed==
{{Arthrocentesis equipment}}

==Procedure==
===General Setup===
*Prep area with betadine or chlorhexadine using circular motion moving away from joint x 3
*Drape joint in sterile fashion 
*Inject lidocaine with 25-30ga needle superficially and then into deeper tissues
*Insert 18ga needle (for larger joints) into joint space while pulling back on syringe 
*Stop once you aspirate fluid; aspirate as much fluid as possible
**Send: cell count, culture, [[Gram Stain]], crystal analysis

===Specific Approach===
*Can be entered medially or laterally to the patella, superior or inferior to patella
*Fully extend knee and ensure quadriceps muscle is relaxed (optionally bump with 20 deg of flexion)
**Place your thumb on the patella and slide it over as you enter with needle
**For Suprapatellar Approach 1 cm lateral and 1 cm superior 
*Identify midpoint of patella; insert needle either 1 cm lateral or medial
*Direct needle posterior to patella and horizontally toward the joint space
*Compression or "milking" applied to both sides of joint space may facilitate aspiration

==Evaluation==
{{Arthrocentesis diagnostic chart}}

==Complications==
{{General arthrocentesis complications}}

==See Also==
*[[Arthrocentesis]]
*[[Arthritis]]
*[[Septic Arthritis (General)]] 
*[[Septic arthritis (peds)]]

==External Links==
*http://www.youtube.com/watch?v=fZ2dcZhoGP8 Arthrocentesis
*http://emprocedures.com/arthrocentesis/introduction.htm

==References==
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[[Category:Procedures]]