20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance

Name of the Procedure:

Arthrocentesis, Aspiration, and/or Injection, Intermediate Joint or Bursa (e.g., Temporomandibular, Acromioclavicular, Wrist, Elbow, Ankle, Olecranon Bursa); Without Ultrasound Guidance

Summary

Arthrocentesis, also known as joint aspiration, is a procedure where a needle is inserted into a joint or bursa to remove fluid for diagnostic purposes or to relieve swelling and pain. It can also involve injecting medications directly into the joint.

Purpose

This procedure helps diagnose joint problems and can alleviate symptoms like pain and swelling. It aims to reduce discomfort, improve joint mobility, and sometimes prevent further joint damage.

Indications

• Severe joint pain or swelling
• Suspected joint infection
• To diagnose conditions like gout or rheumatoid arthritis
• To remove excess fluid due to injury or chronic conditions

Preparation

• Patients may be instructed to avoid certain medications, such as blood thinners, before the procedure.
• No fasting is usually required unless specified by your healthcare provider.
• Inform the doctor about any allergies or current medications.

Procedure Description

1. The patient is positioned comfortably, and the skin over the joint is cleaned.
2. A local anesthetic may be applied to numb the area.
3. A sterile needle is inserted into the joint or bursa to withdraw fluid (aspiration) or inject medication.
4. The needle is then removed, and a bandage is applied to the site.
5. The aspirated fluid is often sent to a lab for further analysis.

Duration

The procedure typically takes about 15-30 minutes.

Setting

Arthrocentesis is usually performed in an outpatient clinic or a doctor’s office.

Personnel

• Orthopedic surgeon or rheumatologist
• Nurse or medical assistant

Risks and Complications

• Infection at the injection site
• Bleeding or bruising
• Allergic reactions to medication
• Pain during or after the procedure
• Rarely, joint damage

Benefits

• Immediate relief from pain and swelling
• Improved joint function
• Accurate diagnosis of joint conditions
• Avoidance of more invasive procedures

Recovery

• Rest the affected joint for a short period.
• Ice packs may reduce swelling and discomfort.
• Avoid strenuous activities for 24-48 hours.
• Follow-up appointments may be necessary for results or additional treatment.

Alternatives

• Oral or topical medications
• Physical therapy
• Other minimally invasive procedures like ultrasound-guided injections
• Surgery in more severe cases

Patient Experience

• Patients may feel a pinch or pressure during needle insertion.
• Some post-procedure soreness is normal and can be managed with over-the-counter pain relievers.
• Most patients can resume normal activities within a day or two.

By following these guidelines, patients can better understand what to expect and how to prepare for the procedure.