20604 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting

Name of the Procedure:

Arthrocentesis, aspiration and/or injection, small joint or bursa (e.g., fingers, toes) with ultrasound guidance, with permanent recording and reporting.

Common Names: Joint Aspiration, Bursa Aspiration, Joint Injection

Summary

Arthrocentesis, commonly known as joint aspiration or injection, is a procedure that involves inserting a needle into a small joint or bursa to withdraw fluid or inject medication. With the aid of ultrasound guidance, this procedure is performed with precision and recorded for permanent documentation.

Purpose

Arthrocentesis is used to diagnose and treat conditions that cause joint or bursal swelling and pain. The goals of the procedure include alleviating pain, reducing inflammation, and diagnosing conditions like gout, arthritis, or infections.

Indications

• Persistent joint or bursal swelling
• Unexplained joint pain
• Suspected joint or bursa infection
• Diagnosing types of arthritis or gout
• Relief from inflammation and pain due to arthritis or injury

Preparation

• Inform your doctor about any medications you are taking.
• You may need to adjust certain medications (e.g., blood thinners) prior to the procedure.
• No fasting is typically required.
• A physical examination and possibly imaging studies (e.g., X-rays) may be needed beforehand.

Procedure Description

1. The area around the joint or bursa is sterilized.
2. Ultrasound is used to guide the accurate placement of the needle.
3. Local anesthesia is applied to numb the area.
4. A needle is inserted into the joint or bursa to either withdraw fluid for diagnosis or to inject medication.
5. The procedure is documented using ultrasound imaging for permanent records.
6. A bandage is placed over the site after the needle is removed.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

Arthrocentesis is usually performed in an outpatient clinic or medical office.

Personnel

• A physician or radiologist (typically skilled in ultrasound-guided procedures)
• A nurse or medical assistant

Risks and Complications

• Infection at the needle insertion site
• Bleeding or bruising
• Temporary pain or discomfort
• Possible nerve damage (rare)
• Allergic reaction to medication (if injection is performed)

Benefits

• Immediate relief from pain and swelling
• Accurate diagnosis of joint or bursal conditions
• Reduced risk of long-term joint damage caused by conditions like gout or infections
• Minimally invasive with a quick recovery time

Recovery

• You may experience mild soreness or swelling at the site.
• Apply ice packs to reduce swelling, if necessary.
• Avoid strenuous activities for 24 to 48 hours.
• Follow-up appointments may be scheduled to review test results or effectiveness of the treatment.

Alternatives

• Oral anti-inflammatory medications
• Physical therapy
• Surgical intervention in severe cases
• Pros: Non-invasive options like medications and therapy might be preferable for managing chronic conditions.
• Cons: Alternatives might not offer immediate relief or diagnostic clarity.

Patient Experience

• You may feel slight pressure or discomfort during the procedure.
• The local anesthesia minimizes pain.
• Post-procedure soreness is usually mild and temporary.
• Pain management includes over-the-counter pain relievers and applying ice to the site.