What is arthrocentesis (joint aspiration)?

By Cristiano Antonino On May 16, 2023

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Joint aspiration (arthrocentesis) is a procedure to remove excess fluid through a needle from a joint (commonly knee, ankle, elbow or hip)

Joint injection involves the injection of drugs, such as corticosteroids, into the joint to relieve pain.

Arthrocentesis (joint aspiration) can help the doctor find the cause of swollen and painful joints

It can also provide symptom relief.

Practitioners use a fine needle to remove (suction) fluid from the affected joint.

After the suction, the doctor may inject medication into the joint.

These medications temporarily relieve pain and inflammation.

What causes joint pain?

Joints are part of your skeletal system.

They are the connection where two bones meet.

Cartilaginous tissue at the ends of the bones helps them move and slide.

Synovial fluid cushions and lubricates the joints and cartilage.

Joint pain, inflammation and swelling occur when something reduces synovial fluid, cartilage or both.

Conditions that cause joint pain include:

Arthritis, including osteoarthritis, gout and psoriatic arthritis.
Autoimmune diseases, including rheumatoid arthritis and lupus.
Bacterial infections, including Lyme disease.
Bursitis and tendonitis.

How does arthrocentesis (joint aspiration) work?

The accumulation of fluid in the joint (effusion) puts pressure on the joint.

The excess fluid causes pain and swelling.

You may find it difficult to bend and move the joint.

Your doctor can drain the fluid and send a sample to a laboratory.

Tests can determine the cause of the fluid accumulation.

As a treatment, joint suction relieves swelling and joint pressure.

You should experience less pain and find it easier to move after this procedure.

Excess fluid often returns.

You may need joint suction again.

Health professionals generally use arthrocentesis on

Hips, knees, ankles and feet.
Elbows, shoulders, wrists and hands.

What are joint injections?

After joint aspiration, the doctor may inject corticosteroids into the joint.

This anti-inflammatory medication relieves pain, swelling and stiffness.

The drugs can also slow the return of excess fluid to the joint.

Steroid injections work best for inflammatory conditions such as arthritis and tendonitis.

The effects of the treatment last for a couple of months.

You should not receive more than four injections in the same joint within a year.

Excessive use of steroids can damage the joint and weaken supporting tendons and ligaments.

What is viscosupplementation?

Viscosupplementation is a type of joint injection that specifically treats arthrosis.

Research on the effectiveness of this treatment shows mixed results.

Some people have less pain and improve movement after treatment.

But some people see no change.

Your doctor injects hyaluronic acid into a joint (usually the knees).

This substance occurs naturally in the synovial fluid that surrounds joints.

You receive one to five injections in a few weeks.

It can take several weeks for symptoms to improve.

Viscosupplementation can relieve pain and improve mobility for about six months.

You can receive treatment again.

How are arthrocentesis (joint aspiration) and joint injections performed?

Joint aspiration and joint injections are performed in your doctor’s office.

Your provider may use images from an ultrasound or X-ray (fluoroscopy) to guide the procedures.

First, your provider disinfects the skin.

For smaller joints, your provider applies a paralysing cream to the skin.

You may need a local anaesthetic to numb a larger joint section such as the hips or shoulders.

During joint aspiration and injection, the doctor

Inserts a fine needle into the joint.
He attaches an empty syringe to the needle and sucks fluid out of the joint (suction). Your provider may need several syringes to remove all the fluid.
He removes the syringe with the excess fluid and replaces it with a syringe containing the drug.
Use the same needle and entry point to inject the drug into the joint.
Place a bandage over the area to be treated.

What should I do after the arthrocentesis (joint aspiration) and joint injections?

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Depending on the area to be treated, this may be necessary:

Do not lift anything heavy or weigh down the treated area for 48 hours.
Take non-steroidal anti-inflammatory drugs (NSAIDs) to relieve discomfort.

What are the potential risks or complications of arthrocentesis (joint aspiration) and joint injections?

Joint aspiration and joint injections are relatively safe.

Rarely, these complications develop:

Allergic reaction: some people are allergic to the anaesthetic or injectable drug. In very rare cases, this can cause anaphylaxis, a life-threatening response.
Infection: Rarely, people develop infections after receiving steroid injections.
Post-injection flare-up: It is estimated that 1 in 50 people develop a post-injection flare-up several hours after receiving an injection. It causes joint swelling and pain that subsides within a few days.