In patients presenting with atraumatic joint pain and swelling, diagnosis is typically made by synovial fluid analysis. Management of an acute suspected hip joint arthritis can present a challenge to the emergency physician (EP). [ncbi.nlm.nih.gov]

Ultrasound is a useful tool to evaluate and initiate diagnostic and therapeutic measures for patients presenting with hip pain suspicious for effusion. [mdedge.com]

• Plethora

  But, you did not cite a plethora of studies noting the efficacy and/or superiority of this method compared to other potential techniques for performing an ankle arthrocentesis and/or injection. [nuemblog.com]

• Fulminant Sepsis

  No, he/she did not suddenly develop fulminant sepsis secondary to septic arthritis, rapidly developing an acute airway issue. There is no other medical mystery to solve here. [nuemblog.com]

• Bilateral Knee Effusion

  She denies any recent trauma to her knee or wounds of any kind. On exam, she is found to have bilateral knee effusions. However, the right knee is erythematous, warm to the touch, and significantly more tender to palpation than the left. [emdocs.net]

Abstract Arthrocentesis is a procedure in the diagnostic workup and treatment of joint pain that has few complications. Analysis of joint fluid yields important treatment data. [ncbi.nlm.nih.gov]

Septic arthritis workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/236299-workup#c8. Accessed 9/9/2016. Sofronescu, A. (Updated 2016 April 13). Joint fluid interpretation. Medscape Reference. [labtestsonline.it]

• Borrelia Burgdorferi

  Synovial fluids suspicious for gonococci or Borrelia burgdorferi may be specifically sent for PCR analysis if the diagnosis is in question. Biochemical studies Glucose. [hss.edu]

  Following the initial tick bite, Borrelia burgdorferi spirochetes invade synovial joints, inducing an inflammatory response in synovial tissue consisting of synovial hypertrophy, vascular proliferation, and infiltration of mononuclear cells. 14 Episodes [ahcmedia.com]

  Following the initial tick bite, Borrelia burgdorferi spirochetes invade synovial joints, inducing an inflammatory response in synovial tissue consisting of synovial hypertrophy, vascular proliferation, and infiltration of mononuclear cells.14 Episodes [reliasmedia.com]

One group received arthrocentesis as initial treatment (n = 40), the other group received conventional treatment including soft diet, physical treatment and occlusal splint therapy (n = 40). Follow-up was after 3, 12 and 26 weeks post treatment. [ncbi.nlm.nih.gov]

Abstract We aimed to assess the relationship between myeloperoxidase (MPO) and internal derangement (ID) of temporomandibular joint (TMJ) and effects of arthrocentesis procedure, either alone or in combination with hyaluronic acid (HA) injection on the prognosis [ncbi.nlm.nih.gov]

Success Rate and Prognosis Several studies have found that arthrocentesis is capable of recovering normal mouth opening and reducing pain and functional disorder. [amsjournal.com]

Intra-articular corticosteroid injection has an unpredictable prognosis and can also lead to local side-effects on the joint. Methods A total of 20 patients (11 females and 9 males) aged 17-39 years were enrolled in this study. [parjournal.net]

Influencing factor on the prognosis of arthrocentesis. J Korean Assoc Oral Maxillofac Surg. 2014; 40:155–159. pmid:25247144 View Article PubMed/NCBI Google Scholar 33. Ness GM: Temporomandibular joint arthrocentesis for acute or chronic closed lock. [journals.plos.org]

In the second case, the patient was determined to have a noninfectious etiology and also did well. Skilled ultrasound guidance allows hip arthrocentesis to be performed by the treating clinician, decreasing the time to diagnosis and definitive care. [ncbi.nlm.nih.gov]

Arthrocentesis (synovial fluid aspiration) of the knee can be performed either diagnostically (for identification of the etiology of acute arthritis) or therapeutically (for pain relief, drainage of effusion, or injection of medications). [1, 2] To avoid [emedicine.medscape.com]

Figure-1:Trend of total and rate of discharges with arthrocentesis -2004-2013 Fig-2:Trend of proportion of arthrocentesis by arthritic etiology Fig-3:Trend of LOS and mortality among discharges with arthrocentesis Disclosure: D. Poudel, None; R. [acrabstracts.org]

Clinical Significance Arthrocentesis is performed for identification of the etiology or pain relief, injection of medications, or effusion drainage. To avoid complications, the clinician should be familiar with the anatomy. [statpearls.com]

[…] joint) >90% Culture Neg Neg Neg >50% positive Lactate <5.6 mmol/L <5.6 mmol/L <5.6 mmol/L >5.6 mmol/L LDH <250 <250 <250 >250 Crystals None None Multiple or none None Viscosity of synovial fluid may actually be decreased in inflammatory or infectious etiologies [wikem.org]

[…] national de la santé et de la recherche médicale (INSERM), UMR 1132, Hôpital Lariboisière; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Lariboisière, Service de Rhumatologie, Centre Viggo Petersen, Pôle Appareil Locomoteur, Paris, France; Epidemiology [ncbi.nlm.nih.gov]

Epidemiology of soft-tissue/musculoskeletal injury among U.S. Marine recruits undergoing basic training. Mil Med. 1992;157:491–3. 20. Barber FA, Sutker AN. Iliotibial band syndrome. Sports Med. 1992;14:144–8. 21. [aafp.org]

A retrospective observational study was conducted based on the Helsinki Declaration and recommendations of the report entitled Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) [16]. [journals.plos.org]

Epidemiologic data on the incidence of CA-MRSA septic arthritis are sparse; however, one recent study noted that 50% of synovial fluid cultures in suspected septic arthritis ultimately grew MRSA. 12 It would be prudent to consider empirical therapy for [clinicalgate.com]

However, thoroughly testing of these treatment modalities in the TMJ itself remains needed, because differences in pathophysiology between the TMJ and other joints may influence the clinical results. [rug.nl]

Pathophysiology of TMJD could be described by several theories: (i) Changes in the shape and position of the articular disk, (ii) biomechanical and biochemical changes in TMJ, (iii) joint overloading may cause hypoxia and on termination of overloading [jdrntruhs.org]

Current concepts review: septic arthritis of the knee pathophysiology, diagnostics, and therapy. Wien Klin Wochenschr 2011;123:191–197. Stutz G, Kuster MS, Kleinstück F, Gächter A. [jkoa.org]

Explain the pathophysiology and6. Explain the pathophysiology and treatment for gouttreatment for gout 7. Emergency Medicine ObjectivesObjectivesObjectivesObjectives 7. Differentiate “rheumatic fever”7. [slideshare.net]

Complex regional pain syndrome: epidemiology, pathophysiology, clinical manifestations, diagnostic tests and therapeutic proposals. Rev Bras Anestesiol. 2002;52(5):618-27. [ Links ] 44. Al-Belasy FA, Dolwick MF. [scielo.br]

Aspiration in cases of hemarthrosis can prevent adhesions. Aspiration can be performed immediately prior to injecting intra-articular medications. [boneandspine.com]

[…] to use only arthrocentesis in patients without preoperative degenerative changes and arthrocentesis with SH in patients with degenerative changes on their preoperative MRIs, but because there were some significant differences between the two groups preventing [ncbi.nlm.nih.gov]

In order to minimize the effects of this process on the quality of life or even preventing it from becoming chronic, adequate intervention is essential. [rug.nl]

While treatment of IMPA is based on chronic immuneosuppressants to help prevent that body from continuing to attack the joints. [vcahospitals.com]

Additional Resources MedlinePlus National Institutes of Health Centers for Disease Control and Prevention Eunice Kennedy Shriver National Institute of Child Health and Human Development U.S. Department of Health & Human Services U.S. [orthomedctr.com]