Athrocentesis Flashcards
Arthrocentesis of shoulder
Access from lateral, bony landmark is acromium, insert needle just distal to acromium in lateral to medial direction
Arthrocentesis of elbow
From medial or lateral into caudal pouch - palpate olecranon process, insert needle a few mm distal to its proximal aspect in a proximodistal and slihtly mediolateral direction
Arthrocentesis of the carpus
From cranial, flex carpal joint and palpate interarticular space, two compartments
- antebrachiocarpal space
- middle carpal + carpometacarpal space
Arthrocentesis of the hip
Patient in lat. recumb, hip upward slightly abducted and externally rotated. Insert needle dorsal to greater trochanter and enter joint in lateral to medial direction
Arthrocentesis of the stifle
Flex stifle to 90 degree angle. Insert needle medial or lateral to the patellar ligament and about half the distance from the tibial vrest to patella. Point toward intercondylar notch.
Long enough needle to avoid fat pad.
Arthrocentesis of the tarsus
alteral aspect of joint. Insert needle in daudodistal aspect of distal fibula at a 30-45¤ angle from caudodistal to cranioproximal and in a distolateral-to-proximomedial direction
Characteristics of synovial fluid - normal
Total nucleated cell cound (WBC/ul) - <3000 in dogs, <1000 in cats
Mononuclear cells - >95 %
Neutrophils - <5 %
Characteristics of synovial fluid - degenerative joint disease
Total nucleated cell cound (WBC/ul) - 1000-10000
Mononuclear cells - >90 %
Neutrophils - <10 %
Characteristics of synovial fluid - Inflammatory joint disease - bacterial infective or immune mediated
Total nucleated cell cound (WBC/ul) - 5000-100000
Mononuclear cells - as low as <10
Neutrophils - 10-90%
Lactate, glucose
Characteristics of synovial fluid - Inflammatory joint disease - haemarthrosis
Number of red cells relative to leukoxytes is similar to blood
Arthrocentesis - samples and priority
- Cytology
- Bacteriology
- EDTA
- Lactate/glucose
