Joint puncture in Vilnius

A joint puncture is a medical procedure that involves puncturing a joint to extract or inject fluid. This method is used by Mano Klinika for both diagnostic and therapeutic purposes. The procedure not only helps to identify the cause of inflammation or pain in the joint, but also to relieve pressure and improve mobility in the event of fluid build-up. In this article, we will discuss the main indications for joint puncture, the types of joint puncture, the stages of the procedure, the possible complications and its role in modern traumatology, rheumatology and orthopaedics.

Joint puncture - indications

The indication for performing the manipulation is:

suspected infectious arthritis (to check for the presence of bacteria or viruses in the joint fluid).
joint pain;
trauma;
an acute or chronic inflammatory process in a joint;
fluid accumulation;
Suspected systemic diseases (rheumatoid arthritis, gout);
allergic inflammation;
check the condition of the menisci;
the need for biochemical analysis.

Contraindications to joint puncture

If the patient has these contraindications, the procedure cannot be performed:

acute purulent processes, burns, wounds, complicated infections at the puncture site;
blood clotting disorder;
systematic use of blood-thinning drugs;
serious degenerative changes, ankylosis and other pathologies that pose a risk of bone trauma during the procedure.

Types of joint perforations

Joint punctures are divided into two types:

Diagnostic.
Therapeutic.

The first is to:

estimate the volume and properties of the synovial fluid;
diagnose meniscal injuries;
Diagnosis of inflammation, confirmation and/or exclusion of trauma, rheumatoid and chronic joint diseases;
detecting and investigating tumours.

If the puncture is for diagnostic purposes, tissue (fluid) is taken for later analysis in the laboratory.

The goals of therapeutic puncture:

to remove purulent exudate;
injections of medicines;
blood removal in haemarthrosis;
anaesthesia before repositioning the dislocated joint;
oxygen injections to mechanically break up fibroids.

How a joint puncture is performed

This procedure does not require any special preparation of the patient. The only important condition is that the patient must inform the doctor in advance of any contraindications (regular use of anticoagulants, allergy to anaesthetics, blood diseases). The doctor may prescribe a laboratory blood test for the patient, as well as a sonographic and radiological examination of the affected joint, if necessary.

The cut is made in several stages:

Disinfection of the skin at the manipulation site.
Anaesthetic injection. Local anaesthesia reduces the pressure on the affected joint, making the procedure completely painless.
The needle is inserted after the anaesthetic has taken effect.
The doctor uses a syringe to draw fluid for examination.
Once the procedure is complete, the puncture site is usually sealed with a patch.

The procedure is performed under ultrasound guidance. Visualisation of the process on a computer monitor allows the specialist to control the movement of the needle, ensuring precision of the manipulation and reducing the risk of complications.

Features of punctures in different joints

Shoulder joint

The incisions are made in different ways and are therefore divided into three types: anterior, posterior and lateral. Despite the different needle insertion site, the technique of these procedures remains identical. The main point of reference for all types of punctures is the acromion-clavicle joint, which is an important anatomical point. In the procedure, the puncture is made perpendicular to the outer layer of the skin. After the puncture, the specialist determines the direction of the needle.

Wrist joint

The incision is made in the lower part of the radius at the back of the wrist. The needle is inserted into the space between the tendons responsible for extending the thumb and index finger, allowing the joint to be penetrated and the necessary manipulation to be carried out.

Elbow joint

The needle is inserted from the back of the elbow. The patient must bend the arm at right angles to allow the doctor to carefully perform the puncture. If it is necessary to penetrate the back of the elbow joint, the puncture is made at the site of the triceps tendon. The needle is then gently guided towards the joint capsule, thus ensuring precise access to the area concerned.

Knee joint

The puncture shall be carried out above the upper edge of the road. The needle is inserted slowly in a circular motion. This method minimises trauma to the surrounding tissues and facilitates access to the joint cavity.

Member of the club

The cut can be made either sideways or anteriorly. In the lateral approach, the needle is introduced through the upper surface of the greater glenoid and pushed in the frontal plane. In the anterior approach, the needle is introduced into the anterior part of the joint perpendicular to the upper edge of the femoral head to ensure accurate entry into the joint cavity.

Ankle joint

For an ankle puncture, the needle is inserted anteriorly, between the tendon of the extensor digitorum and the outer part of the ankle. This approach allows access to the joint cavity and the necessary manipulation with minimal risk to the surrounding tissues.

Thus, joint puncture is an important diagnostic and therapeutic tool for the diagnosis and treatment of joint diseases and injuries, contributing to the improvement of the patient's condition and prevention of complications.

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Joint puncture