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Diagnostic Indications

  • To evaluate synovial fluid and determine whether an effusion has an infectious, rheumatic, traumatic, or crystal-induced origin
  • To differentiate an intra-articular from an extra-articular cause of pain symptoms

Therapeutic Indications

  • To remove exudative fluid from a septic joint
  • To relieve pain in a grossly swollen joint (e.g., traumatic effusion)
  • Cellulitis or broken skin over the intended entry site for aspiration
  • Anticoagulant therapy that is not well controlled
  • Severe primary coagulopathy
  • Suspected bacteremia
  • Joint prostheses
  • Pregnancy (relative)
  • Povidone-iodine wipes or alcohol wipes
  • Sterile or nonsterile gloves
  • Sterile drapes (optional)
  • 18- to 21-gauge, 1½-inch needle for aspirations
  • 30-gauge, ½-inch needle, and 1% lidocaine, if skin anesthesia is to be given
  • 3- to 50-mL syringe for aspirations
  • Hemostat (optional)
  • Tubes for culture or other laboratory studies
  • Adhesive bandage dressing

Knee Joint

Prepatellar Bursa

The prepatellar bursa lies subcutaneously, directly superficial to the patella.

Anserine Bursa

The anserine bursa lies beneath the common insertion of the senitendinosus, gracilis, and sartorius tendons on the medial aspect of the tibia.

Baker's Cyst (Popliteal Cyst)

  • The popliteal artery and vein and the tibial and common peroneal nerves traverse the popliteal cavity.

Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • Apply an adhesive bandage dressing or other dressing over the aspiration site.
  • Advise the patient to report immediately any fever, chills, or sign of infection.
  • The patient may bathe normally.
  • Bleeding due to trauma to an artery or vein
  • Introduction of infection
  • Trauma to articular cartilage
  • Injury to nearby nerves
  • Inappropriate diagnosis
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