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
Send: cell count, culture, Gram Stain, crystal analysis
Can be entered medially or laterally to the patella, superior or inferior to patella
Fully extend<unk>  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
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
Arthrocentesis: knee
Arthrocentesis: elbow
Arthrocentesis: ankle
Arthrocentesis: shoulder
Arthrocentesis: hip
Arthrocentesis: wrist
Arthrocentesis: finger
Arthrocentesis: toe