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Arthrocentesis in the Elderly

  • Ahmed S. ZayatEmail author
  • Richard J. Wakefield
Chapter

Abstract

Joints aspiration and injections are common practice in the elderly medicine and can be used to diagnose and treat some of the musculoskeletal conditions. Joint injection is a relatively safe procedure if associated with good knowledge of anatomy and awareness of the potential complications and contraindications. Different approaches can be used for arthrocentesis, but the discussed techniques in this chapter are the ones used most commonly by the authors. Appropriate training involves knowledge of anatomy and practical skills are key requirements.

Keywords

Arthrocentesis Joints injections Joints aspiration Soft tissue injection Intra-articular injection 

References

  1. 1.
    Kerlan RK, Glousman RE. Injections and techniques in athletic medicine. Clin Sports Med. 1989;8:541–60.PubMedGoogle Scholar
  2. 2.
    Centeno LM, Moore ME. Preferred intra-articular corticosteroids and associated practice: a survey of members of the American College of Rheumatology. Arthritis Care Res. 1994;7:151–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Derendorf H, Möllmann H, Grüner A. Pharmacokinetics and pharmacodynamics of glucocorticoid suspensions after intraarticular administration. Clin Pharmacol Ther. 1986;39:313–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;19:CD005321.Google Scholar
  5. 5.
    Kotz R, Kolarz G. Intra-articular hyaluronic acid: duration of effect and results of repeated treatment cycles. Am J Orthop. 1999;28(11):5–7.PubMedGoogle Scholar
  6. 6.
    Wobig M, Dickhut A, Maier R, Vetter G. Viscosupplementation with hylan G-F 20: a 26-week controlled trial of efficacy and safety in the osteoarthritic knee. Clin Ther. 1998;20:410–23.PubMedCrossRefGoogle Scholar
  7. 7.
    Caborn D, Rush J, Lanzer W, Parenti D. Synvisc 901 Study Group. A randomized, single-blind comparison of the efficacy and tolerability of hylan G-F 20 and triamcinolone hexacetonide in patients with osteoarthritis of the knee. J Rheumatol. 2004;31:333–43.PubMedGoogle Scholar
  8. 8.
    Aggarwal A, Sempowski IP. Hyaluronic acid injections for knee osteoarthritis. Systematic review of the literature. Can Fam Physician. 2004;50:249–56.PubMedGoogle Scholar
  9. 9.
    Pal B, Morris J. Perceived risks of joint infection following intra-articular corticosteroid injections: a survey of rheumatologists. Clin Rheumatol. 1999;18:264–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Farooq MA, Devitt AT. Perceived efficacy and risks of infection following intra-articular injections: a survey of orthopaedic surgeons. Ir J Med Sci. 2005;174:26–32.PubMedCrossRefGoogle Scholar
  11. 11.
    Hartmann H. [Arthrocentesis in rheumatology practice]. Tidsskr Nor Laegeforen. 2000;120:800–2.PubMedGoogle Scholar
  12. 12.
    Charalambous CP, Tryfonidis M, Sadiq S, Hirst P, Paul A. Septic arthritis following intra-articular steroid injection of the knee – a survey of current practice regarding antiseptic technique used during intra-articular steroid injection of the knee. Clin Rheumatol. 2003;22:386–90.PubMedCrossRefGoogle Scholar
  13. 13.
    Cassidy JT, Bole GG. Cutaneous atrophy secondary to intra-articular corticosteroid. Ann Intern Med. 1966;65:1008–18.PubMedGoogle Scholar
  14. 14.
    McCarty DJ, McCarthy G, Carrera G. Intraarticular corticosteroids possibly leading to local osteonecrosis and marrow fat induced synovitis. J Rheumatol. 1991;18:1091–4.PubMedGoogle Scholar
  15. 15.
    Luzar MJ, Altawil B. Pseudogout following intraarticular injection of sodium hyaluronate. Arthritis Rheum. 1998;41:939–40.PubMedCrossRefGoogle Scholar
  16. 16.
    Goldberg VM, Coutts RD. Pseudoseptic reactions to hylan viscosupplementation: diagnosis and treatment. Clin Orthop Relat Res. 2004;419:130–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Chen AL, Desai P, Adler EM, Di Cesare PE. Granulomatous ­inflammation after Hylan G-F 20 viscosupplementation of the knee: a report of six cases. J Bone Joint Surg Am. 2002;84-A:1142–7.PubMedGoogle Scholar
  18. 18.
    CKS. Rheumatoid arthritis. 2005. http://cks.library.nhs.uk/rheumatoid_arthritis/management/quick_answers/scenario. Accessed 20 July 2008.
  19. 19.
    Weitoft T, Uddenfeldt P. Importance of synovial fluid aspiration when injecting intra-articular corticosteroids. Ann Rheum Dis. 2000;59:233–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Jones A, Regan M, Ledingham J, Pattrick M, Manhire A, Doherty M. Importance of placement of intraarticular steroid injections. Br Med J. 1993;307:1329–30.CrossRefGoogle Scholar
  21. 21.
    Chakravarty K, Pharoah PDP, Scott DGIA. Randomised controlled study of post-injection rest following intra-articular steroid therapy for knee synovitis. Br J Rheumatol. 1994;33:464–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Chard MD, Hazleman BL. Shoulder disorders in the elderly (a hospital study). Ann Rheum Dis. 1987;46:684–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Chard MD, Hazleman R, Hazleman BL, King RH, Reiss BB. Shoulder disorders in the elderly (a community survey). Arthritis Rheum. 1991;34:766–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Mahakkanukrauh P, Surin P. Prevalence of osteophytes associated with the acromion and acromioclavicular joint. Clin Anat. 2003;16:506–10.PubMedCrossRefGoogle Scholar
  25. 25.
    Stein BE, Wiater JM, Pfaff HC, Bigliani LU, Levine WN. Detection of acromioclavicular joint pathology in asymptomatic shoulders with magnetic resonance imaging. J Shoulder Elbow Surg. 2001;10:204–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Sellman JR. Plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int. 1994;15:376–81.PubMedGoogle Scholar
  27. 27.
    Tsai WC, Hsu CC, Chen CP, Chen MJ, Yu TY, Chen YJ. Plantar fasciitis treated with local steroid injection: comparison between sonographic and palpation guidance. J Clin Ultrasound. 2006;34:12–6.PubMedCrossRefGoogle Scholar
  28. 28.
    Kane D, Greaney T, Bresnihan B, Gibney R, FitzGerald O. Ultrasound guided injection of recalcitrant plantar fasciitis. Ann Rheum Dis. 1998;57:383–4.PubMedCrossRefGoogle Scholar
  29. 29.
    Jones A, Regan M, Ledingham J, Pattrick M, Manhire A, Doherty M. Importance of placement of intra-articular steroid injections. BMJ. 1993;307:1329–30.PubMedCrossRefGoogle Scholar
  30. 30.
    Raza K, Lee CY, Pilling D, Heaton S, Situnayake RD, Carruthers DM, et al. Ultrasound guidance allows accurate needle placement and aspiration from small joints in patients with early inflammatory arthritis. Rheumatology (Oxford). 2003;42:976–9.CrossRefGoogle Scholar
  31. 31.
    Migliore A, Tormenta S, Martin Martin LS, Valente C, Massafra U, Latini A, et al. Safety profile of 185 ultrasound-guided intra-articular injections for treatment of rheumatic diseases of the hip. Reumatismo. 2004;56:104–9.PubMedGoogle Scholar
  32. 32.
    Sofka CM, Saboeiro G, Adler RS. Ultrasound-guided adult hip injections. J Vasc Interv Radiol. 2005;16:1121–3.PubMedGoogle Scholar
  33. 33.
    Naredo E, Cabero F, Beneyto P, Cruz A, Mondéjar B, Uson J, et al. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol. 2004;31:308–14.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.The Academic Unit of Musculoskeletal Diseases, LIMM-Leeds Institute of Molecular MedicineUniversity of Leeds, Chaple Allerton HospitalLeedsUK

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