joint aspiration

joblist: technique

Midpoint approach: 1 cm lateral or medial to the patella, directing the needle posterior and horizontal toward the intercondylar notch of the femur.
Infrapatellar approach: With knee flexed to 90°, needle inserted 5 mm below the patella’s inferior border, posterior to the patellar tendon

Complications
Local trauma, pain, infection, dry tap
Haemoarthrosis - usually self-limiting

interpretation

Type Colour & Clarity WBCs (cells/mm3) Neutrophils (%) Viscosity Crystals Culture
Normal Clear colourless < 200 < 25 High Neg Neg
Non-inflammatory e.g. Osteoarthritis Clear yellow 200 - 2000 < 25 High Neg Neg
Inflammatory (e.g. Rheumatoid arthritis) Cloudy yellow 2000 - 50000 ≥ 50 Low Pos (gout/pseudogout) Neg
septic arthritis Cloudy yellow/green > 50000 ≥ 75 Low Neg Pos
Haemorrhagic Bloody red 200 - 2000 50-75 Variable Neg Neg