In short
Joint aspiration draws a small sample of fluid from a swollen joint with a fine needle, so it can be examined under a microscope. The same needle can then deliver a corticosteroid directly into the joint. It takes a few minutes, is done under local anaesthetic, and often answers a diagnostic question that weeks of blood tests could not.
Why the fluid matters
A swollen joint has a short list of possible causes, and they need completely different treatment. Crystals under polarised light confirm gout or pseudogout. A high white cell count and a positive culture mean infection, which is an emergency. A modest inflammatory count with no crystals and no organisms points towards inflammatory arthritis. Blood tests cannot separate these three with the same certainty.
What happens during the procedure
The skin is cleaned and local anaesthetic is used. A fine needle is placed into the joint space, fluid is withdrawn, and — if the diagnosis is already clear and infection has been excluded — a long-acting corticosteroid is injected through the same needle before it is removed. Most people describe pressure rather than pain.
Which joints
The knee is the most straightforward. Shoulder, ankle, wrist, elbow and the small joints of the hand and foot are all routinely done, with ultrasound guidance where the target is small or deep.
Afterwards
Rest the joint for the remainder of the day. Relief from an injection usually begins within one to three days and can last for weeks to months, depending on the underlying condition. An injection treats the inflammation in that joint; it does not treat the disease driving it, so it is used alongside a disease-modifying plan rather than instead of one.
What it does not do
Repeated steroid injections into the same joint are avoided. If a joint needs injecting again and again, the right response is to reconsider the systemic treatment, not to keep injecting.
Conditions this is used for
These are the conditions in which Joint Aspiration & Injection forms part of the assessment or the treatment plan. It is not a complete list, and whether it applies to you is decided at consultation.
- Rheumatoid Arthritis
- Psoriatic Arthritis
- Reactive Arthritis
- Enteropathic Arthritis
- Gout
- Osteoarthritis
Whether a procedure is appropriate is decided during consultation, based on your symptoms, examination and existing reports.
Book your consultation
Consult Dr. Ashish Baweja at the Institute of Clinical Immunology and Rheumatology, Medanta – The Medicity, Gurugram.