canis - Articles
Arthrocentesis: overview
Synonym(s): Joint fluid collection
Introduction
- To withdraw a sample of synovial fluid for analysis Synovial fluid: cytology , as an ancillary aid to diagnosis of joint pathology.
- Fluid samples can be obtained from virtually any joint in which an effusion can be palpated.
Uses
→- Investigation of persistent or cyclic pyrexia , associated with a generalized stiffness or lameness - multiple joints should be examined. →
- An ancillary aid to diagnosis in many joint conditions (effusions, stiffness or pain), and identifying underlying joint pathology (inflammatory, infectious, neoplastic Synovial cell sarcoma ). →
- Insertion of contrast media for radiographic examination. →
- Intrasynovial administration of drugs.
Advantages
- Immediate subjective assessment of color and viscosity of synovial fluid.
- Differentiates major classifications of joint disease, ie infectious from non-infectious and inflammatory from non-inflammatory disorders.
- Multiple joints may be sampled.
- Does not always require sedation.
Disadvantages
- Yields small volumes of fluid. Therefore, may need to sample more than one joint.
- Some joints require analgesia.
- Multiple sampling from same joint may confuse interpretation due to iatrogenic bleeding.
Alternative techniques
- Synovial membrane biopsy Biopsy: synovia , can provide more definitive diagnosis in some cases of inflammatory arthropathy and synovial tumors.
- Arthroscopy in large joints of medium to large dogs for visualization of joint surfaces and collection of biopsy material.
- Arthrotomy Joint lavage , can give a more complete assessment of traumatic injuries to the hard and soft joint tissues.
Time required
Preparation
- 5 mins site preparation; longer if anesthesia/sedation is required.
Procedure
- Minimum 5 mins, depending on joint to be sampled and experience of technician in locating and entering joint space.
Decision taking
Criteria for choosing test
- Radiographs that indicate affected joint.
- Obviously enlarged joint.
- Do not enter joint with overlying skin infection or lesion.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Clements D (2006) Arthrocentesis and synovial fluid analysis in dogs and cats. In Practice 28 (5), 256-262 VetMedResource.