Arthrocentesis for Acute Gouty Arthritis

Acute Gouty Arthritis

Acute gouty arthritis is a type of arthritis caused by the build up of uric acid in the synovial fluid. The accumulation of uric acid in the joint fluid usually form into crystals and result in gouty arthritis, which is one of the most painful form of rheumatic diseases. It is characterized by severe pain, redness, inflammation and swelling of the joints. The joint of the big toe is commonly affected in about 3/4 of people with gouty arthtritis. Other joints in the body such as those in the fingers, wrists, elbows, knees and ankles may also be affected. In most cases, acute gouty arthritis affects only one joint during an attack.

The exact cause of the disease is unknown, although it may run in families. It rarely occur in children, but is more likely to develop in older men, postmenopausal women, obese pepole, alcoholic drinkers and patients taking diuretics. People with kidney disease, diabetes and anemia also have increased risk of developing gouty arthritis.

Symptoms of acute gouty arthtritis usually starts suddenly in one joint or sometimes in a few joints. Patients often complain of throbbing pain in the joints that usually occur at night, fever and redness of the affected joint which is also warm to the touch.

Arthrocentesis

Arthrocentesis is a medical procedure wherein synovial fluid are drained from the joint for testing. The fluid is then send to the laboratory for analysis.The purpose of the procedure is to establish the cause of swelling or pain in the joint. It is also used to relieve the pressure which causes pain in the joint. The entire procedure is usually painless and lasts for about a few minutes.

In the laboratory, the joint fluid is analyzed for its appearance including its color and clarity, its contents such as glucose and protein, and it is also examined under the microscope for the presence of blood cells, crystals and bacteria.

How is Arthrocentesis Done?

Patients are placed in a comfortable position with the affected joint properly identified and positioned. After skin preparation is done, the landmark for needle entry is verified in order to avoid hitting the bone. Once the physician is certain of the site, he or she inserts the needle into the joint space and slowly apirates synovial fluid into the syringe. The needle is then removed and a sterile bandage is applied over the site. The synovial fuid is then sent to the laboratory for examination.

Is it an Effective Treatment?

Arthrocentesis may temporarily relieve pain in acute gouty arthtritis. The removal of the fluid from the joint frequently lessens the pressure, thus pain is also decreased. However, the patient must also take the prescribed medications given by doctors and to follow the recommended changes in diet and lifestyle in order to prevent another attack.

References

Medline Plus: Gout

The Multimedia Procedure Manual: Arthrocentesis Procedure