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Arthrocentesis Procedures News
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All Recent Arthrocentesis Procedures News |
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TMJ arthroscopy in patients with Ehlers Danlos syndrome: case series
Conclusion: For patients where conservative measures of treating TMD are not effective, arthroscopy is a minimally invasive surgical procedure that has been shown to result in a satisfactory outcome, with no need to resort to open joint surgery. This case series is limited by its size and further research on surgical intervention on EDS patients with temporomandibular disorders is recommended. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)...
POSTED 07/27/2010 at 12:41 AM --
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Re: A new anatomical landmark to simplify temporomandibular joint arthrocentesis
We read with interest the technical note from Alkan and Etöz. Temporomandibular joint arthrocentesis is used in the management of joint disorders. This procedure, if performed correctly, it can alleviate pain and increase mouth opening. As it is stated by the authors in some cases it is difficult to insert the needle in the desirable position in the joint and the procedure fails to provide some benefit. The two needle technique was described by Nitzan et al. and may used effectively in a large group of patients. In our experience the Shepard cannula is a more effective way of performing joint lavage and has been used in our practice for many years. The authors stated in this technical note that the size of the Shepard cannula may be a risk to the facial nerve and blunting of its tip may i......
POSTED 07/07/2010 at 06:00 PM --
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Ferritin concentrations in synovial fluid are higher in osteoarthritis patients with HFE gene mutations (C282Y or H63D).
Conclusions: A predicted difference in SF ferritin concentrations in patients with knee OA was confirmed. Concentrations of ferritin in the SF were found to be two- to threefold higher in knee OA patients with HFE gene mutations compared to wt patients. This finding is consistent with the possibility that, in OA patients with HFE gene mutations, localized iron overload may contribute either directly or indirectly to osteochondral damage, possibly in a similar way to that which occurs in the arthropathy that complicates HH.
PMID: 20560808 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Rheumatology)...
POSTED 06/20/2010 at 06:00 PM --
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Kynurenine inhibits chondrocyte proliferation and is increased in synovial fluid of patients with septic arthritis
In this study, we analyzed the putative diagnostic value of kynurenine for bacterial joint infection and its potential harmful effects on cartilage. In a prospective study 41 patients with a joint effusion who had undergone arthrocentesis were included. Tryptophan and kynurenine levels from synovial fluid were quantified by HPLC. Diagnostic value of kynurenine was evaluated and its effects on the proliferation of the chondrocyte cell line ATDC5 were determined. Synovial fluid kynurenine values from patients with septic arthritis (4.1 ± 0.8 µmol/L, n = 9) were significantly increased compared to patients with non-infectious inflammatory arthropathy (1.8 ± 0.2 µmol/L, n = 17) or osteoarthritis (1.2 ± 0.1 µmol/L, n = 15, p < 0.01). At a cut-off value of 2.28 µmol/L kynurenine had a sen......
POSTED 05/17/2010 at 06:00 PM --
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Poor performance of microbiological sampling in the prediction of recurrent arthroplasty infection
Abstract During a two-stage revision for prosthetic joint infections (PJI), joint aspirations, open tissue sampling and serum inflammatory
markers are performed before re-implantation to exclude ongoing silent infection. We investigated the performance of these
diagnostic procedures on the risk of recurrence of PJI among asymptomatic patients undergoing a two-stage revision. A total
of 62 PJI were found in 58 patients. All patients had intra-operative surgical exploration during re-implantation, and 48
of them had intra-operative microbiological swabs. Additionally, 18 joint aspirations and one open biopsy were performed before
second-stage reimplantation. Recurrence or persistence of PJI occurred in 12 cases with a mean delay of 218 days after re-implantation,
but on......
POSTED 04/26/2010 at 12:56 AM --
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[The usefulness of ultrasonography in synovial disease.]
Authors: Bargiela A
Synovial disease is common in clinical practice and can have different causes. The development of high resolution ultrasonography (US) has led to greater use of US in the study of synovial disease. In this context, US is useful because (1) it can detect not only synovial disease, but also its consequences as tissue damage (erosions); (2) it can guide arthrocentesis when clinical attempts to obtain joint fluid have been unsuccessful, especially in joints that are difficult to access (hips), or sometimes when joint infections are clinically suspected; (3) it enables the efficacy of treatment for synovitis to be evaluated; and (4) it makes it possible to distinguish benign cystic lesions from other tumors. The overall evaluation of synovial disease is based on semiolog......
POSTED 04/05/2010 at 06:00 PM --
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Teaching knee joint aspiration to medical studentsâan effective training with long-term benefits
The objective of this study was to assess the effectiveness of undergraduate training in knee aspiration and to determine
the impact this had on subsequent postgraduate clinical practice. This paper is a cohort study of undergraduate training with
a cross-sectional questionnaire study of postgraduate practice. The study was held at the University of Cambridge and NHS
hospitals in the Eastern Region Postgraduate Deanery (England). The main outcome measures are the undergraduate competence
in practical skills in a simulated setting and the differences in postgraduate practice with or without prior undergraduate
training in knee aspiration. Implementing an undergraduate training programme in knee aspiration resulted in student competence
in this skill. Undergraduate teaching of knee asp......
POSTED 04/02/2010 at 03:49 AM --
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Monoarticular septic arthritis in a patient with juvenile rheumatoid arthritis under etanercept treatment
Abstract A 7-year-old girl with polyarticular type juvenile rheumatoid arthritis (JRA) presented with acute onset of right hip pain
with limited range of motion and fever within the past two days. She had received etanercept for more than one year. Percutaneous
arthrocentesis was performed and showed a white blood cell count of 84150/μL in the synovial fluid, although the culture showed
negative results. The fever and right hip pain completely resolved after antibiotic treatment. Herein, we report the first
case of septic monoarthritis of JRA under etanercept treatment.
Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00296-010-1459-5Authors
Kai-Cheng Lin, Chang Gung Memorial Hospital-Kaohsiung Medical Center Department of Family Medicine Kaohsiung Taiwan......
POSTED 03/28/2010 at 12:50 AM --
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Effect of Needle Size and Type, Reuse of Needles, Insertion Speed, and Removal of Hair on Contamination of Joints with Tissue Debris and Hair after Arthrocentesis
To assess joint contamination with tissue and hair after arthrocentesis of equine fetlock joints. Experimental. Limb specimens from 8 equine cadavers. Soft tissues including the joint capsule were harvested from the dorsal aspect of the fetlock joints and mounted on a wooden frame. Needles inserted through the joint tissue preparation were flushed into tissue culture plates that were examined for tissue and hair debris. Variables evaluated were gauge and type of needle (16, 18, 20, and 22 G sharp disposable needles and 20 G disposable spinal needles with stylet), number of times each needle was used (1, 2, 3, 4), length of hair (unclipped, clipped, shaved with razor), and needle insertion speed (fast, slow). Descriptive and statistical evaluations were performed. Tissue contamination was i......
POSTED 03/18/2010 at 07:00 PM --
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Intra-articular injection of tenoxicam following temporomandibular joint arthrocentesis: a pilot study
This study examined the clinical and radiological effects of intra-articular tenoxicam injection following arthrocentesis and compared them with arthrocentesis alone in patients with disc displacement without reduction (DDwoR). 24 temporomandibular joints (TMJs) in 21 patients with DDwoR were studied. Patients were divided randomly into Group A in which only arthrocentesis was performed (14 TMJs in 14 patients) and Group AT which received arthrocentesis plus intra-articular injection of tenoxicam (10 TMJs in 7 patients). Patients were evaluated before the procedure, on postoperative day 7, then 2, 3, 4 weeks, and 2, 3, 4, 5, 6 months postoperatively. Intensity of joint pain was assessed using a visual analog scale. Maximum mouth opening was recorded at each follow-up. TMJ sounds and palpat......
POSTED 03/07/2010 at 06:00 PM --
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Centesis Studies in Critical Care
Critical care nurses have a vital role in caring for patients undergoing centesis studies. Any centesis procedure involves puncturing a body cavity, joint, organ, or space with a hollow needle to withdraw fluid. All centesis studies are invasive procedures, typically performed for either therapeutic or diagnostic purposes. Because there are a variety of centesis procedures that the critical care nurse might encounter, the following centesis procedures are discussed in depth: amniocentesis, arthrocentesis, lumbar puncture, paracentesis, pericardiocentesis, and thoracentesis. By becoming more familiar with each of these procedures, the critical care nurse gains confidence in caring for clients when these procedures are indicated. (Source: Critical Care Nursing Clinics of North America)...
POSTED 02/28/2010 at 06:00 PM --
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Analgesic Effects of Intra-Articular Morphine in Patients With Temporomandibular Joint Disorders: A Prospective, Double-Blind, Placebo-Controlled Clinical Trial
Conclusions: Independent of the applied substances, initial pain relief can be registered in the TMJ: either from the arthrocentesis effect or at least the placebo effect. Morphine at a dosage of 10 mg showed the best and most long-lasting analgesic efficiency. Morphine, in general (5 and 10 mg), and, with limitations, Carbostesin were more or less efficient for postoperative pain control but without distinct effects in the long term. With regard to our results, we can recommend intra-articular morphine application at a dose of 10 mg for pain management. Carbostesin showed no promising long-term effects. (Source: Journal of Oral and Maxillofacial Surgery)...
POSTED 02/23/2010 at 08:21 AM --
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A case of gouty arthritis following percutaneous radiofrequency ablation for hepatocellular carcinoma.
We describe a case of acute gouty arthritis in a 71-year-old man with chronic renal failure who was treated with RFA for a HCC lesion and who had hepatitis B-associated cirrhosis and mild renal insufficiency. Regular surveillance of the patient detected a 3.5 cm HCC lesion. Because the patient had declined surgery, RFA was chosen for therapy. On the third post-procedural day, the laboratory results showed increases in his uric acid and potassium levels, which were compatible with a tumor lysis syndrome. On the 6th post-procedural day, the patient complained of new right knee pain. Subsequent joint aspiration revealed monosodium urate monohydrate crystals. We made the diagnosis of acute gouty arthritis arising from tumor lysis and liver infarction caused by HCC ablation, which was aggravate......
POSTED 02/06/2010 at 06:26 PM --
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Is There a Role for Tissue Biopsy in the Diagnosis of Periprosthetic Infection?
CONCLUSIONS: Our data suggest tissue biopsy alone offers no clear advantage over joint aspiration. However, the combination of both techniques provides improved sensitivity and accuracy. We recommend the use of tissue biopsy as an adjunct to joint aspiration in the diagnosis of total joint infection. LEVEL OF EVIDENCE: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
PMID: 20131022 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)...
POSTED 02/03/2010 at 06:00 PM --
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Supervising the SupervisorsâProcedural Training and Supervision in Internal Medicine Residency
CONCLUSIONS Residents report low levels of comfort and experience with procedures, and frequently report supervising prior to feeling
comfortable. Our findings suggest a need to examine best practices for procedural supervision of trainees.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11606-009-1226-zAuthors
Michelle Mourad, University of California San Francisco Department of Medicine, Division of Hospital Medicine 533 Parnassus Ave Box 0131 San Francisco CA 94143 USAJeffrey Kohlwes, University of San Francisco California Department of Medicine, Division of General Internal Medicine San Francisco USAJudith Maselli, University of California San Francisco Department of Medicine, Division of Hospital Medicine 533 Parnassus Ave Box 0131 San Francisc......
POSTED 01/14/2010 at 06:47 PM --
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Relationship of Synovial Tumor Necrosis Factor α and Interleukin 6 to Temporomandibular Disorder
Conclusion: In our analysis of 2 proinflammatory cytokines, TNF-α and IL-6, in the synovial fluid of temporomandibular disorder patients with symptoms of pain, mouth opening limitation, and clicking, both were elevated without statistical significance. (Source: Journal of Oral and Maxillofacial Surgery)...
POSTED 12/22/2009 at 06:00 PM --
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Septic Arthritis of the Temporomandibular Joint: A Retrospective Review of 40 Cases
Conclusions: Septic arthritis of the temporomandibular joint mainly arises from hematogenous spread, but the original infection is often occult. Antibiotic therapy, arthrocentesis under low pressure, and joint immobilization are recommended for patients in the acute stage. The common sequela is osteoarthritis. (Source: Journal of Oral and Maxillofacial Surgery)...
POSTED 12/02/2009 at 06:00 PM --
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Musculoskeletal Complications of Hemophilia
Abstract The most important clinical strategy for management of patients with hemophilia is the avoidance of recurrent hemarthroses
by means of continuous, intravenous hematological prophylaxis. When only intravenous on-demand hematological treatment is
available, frequent evaluations are necessary for the early diagnosis and treatment of episodes of intra-articular bleeding.
The natural history of the disease in patients with poorly controlled intra-articular bleeding is the development of chronic
synovitis and, later, multi-articular hemophilic arthropathy. Once arthropathy develops, the functional prognosis is poor.
Treatment of these patients should be conducted through a comprehensive program by a multidisciplinary hemophilia unit. Although
continuous prophylaxis can ......
POSTED 11/17/2009 at 05:39 PM --
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Septic Arthritis in Adults with Sickle Cell Disease Often is Associated with Osteomyelitis or Osteonecrosis.
CONCLUSIONS: The incidence of septic arthritis in adults with SCD is low, but often is associated with osteomyelitis or osteonecrosis. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
PMID: 19885711 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)...
POSTED 11/02/2009 at 06:00 PM --
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Certification Is Good for Hospital Medicine
DR. DEITELZWEIG is vice president for medical affairs and chairman of hospital medicine at the Ochsner Clinic Foundation in New Orleans The development of a new pathway for certification with Focused Practice in Hospital Medicine is good news for hospitalists. Ideally, hospital medicine would be its own subspecialty, especially since it involves specialized knowledge and the performance of procedures that aren't done in a typical office-based practice, such as vascular access, lumbar puncture, ECG interpretation, and arthrocentesis. But this credential does provide recognition of what we do, and it reflects a natural evolution of hospital medicine. (Source: Hospitalist News)...
POSTED 10/31/2009 at 07:00 PM --
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