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Arthrocentesis of the Knee

Source: content.nejm.org
Topic: Arthropathies
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Sort Desciption: Arthrocentesis is used to establish the cause of an acute monoarthritis or polyarthritis. Nongonococcal bacterial arthritis is a do-not-miss diagnosis, since a delay in identification and treatment may lead to clinically significant joint destruction and even death. ...

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INDICATIONS Arthrocentesis is used to establish the cause of an acute monoarthritis or polyarthritis. Nongonococcal bacterial arthritis is a do-not-miss diagnosis, since a delay in identification and treatment may lead to clinically significant joint destruction and even death. Other infectious causes include disseminated gonococcal infections, tuberculosis, fungal infections, and Lyme disease. Crystal arthropathies (gout and pseudogout), rheumatic disorders, osteoarthritis, trauma, and hemarthrosis may also lead to acute joint effusions. 1 Arthrocentesis is also used as a therapeutic procedure, to drain large effusions or hemarthroses, and to instill corticosteroids or local anesthetic. CONTRAINDICATIONS Arthrocentesis should be avoided in patients with cellulitis overlying the site of needle entry. Suspected bacteremia is a relative contraindication to arthrocentesis; if septic arthritis is suspected, however, the procedure should be performed. The safety of arthrocentesis has not been established for patients with coagulopathy or patients who are receiving anticoagulant medications, and the use of reversal agents or products (e.g., fresh-frozen plasma or platelet ...

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