Joint puncture is aimed at facilitating the functioning of the joint and involves pumping out fluid from the intra-articular cavity. Typically, puncture is used for internal injuries (ligament ruptures, dislocations), when the joint cavity fills with blood or other inflammatory fluid, causing pain during movement and limiting the mobility of the joint in the area of injury. The accumulation of blood in an injured joint can lead to synovitis, intra-articular adhesions, obliteration of the articular cavity, disrupt the blood circulation and even lead to gangrene.
At its core, a puncture is a puncture of a joint to collect fluid or administer medications. The goal is to relieve pain and increase range of motion.
Punctures are divided into therapeutic and diagnostic.
The objectives of a therapeutic puncture are to remove the inflammatory fluid, rinse the joint cavity and fill it with anti-inflammatory and painkillers. Therapeutic puncture is especially effective for connective tissue diseases (arthrosis, polyarthrosis, Reiter's disease, etc.).
Baker's cyst puncture under ultrasound control at the Paracelsus clinic, Aleksandrov
ATTENTION:
Online consultations with doctors (more than 18 specialties) are available.
Baker's cyst puncture under ultrasound guidance
- This is a puncture into the joint cavity, used for diagnostic, therapeutic, therapeutic and diagnostic purposes. This need is often caused by synovitis (accumulation of fluid in the joint cavity), which can occur both in arthrosis and in inflammatory diseases of the joints.
Baker's cyst
(popliteal fossa cyst)
is a tumor-like formation located in the popliteal fossa. The presence of a popliteal fossa cyst negatively affects the function of not only the knee joint, but also the entire lower limb.
Baker's cyst occurs in various diseases of the knee joint, damage to articular cartilage, osteoarthritis, inflammation of the synovial membrane of the joint, degenerative changes in the meniscus, rheumatoid arthritis, patellofemoral arthrosis, and joint injuries.
During the procedure, a traumatologist-orthopedist at the Paracelsus Medical Center, under ultrasound control, evacuates synovial fluid from the joint, which is sent to the laboratory for cytological, microscopic or bacteriological examination. These methods help the doctor diagnose the cause of synovitis.
Indications for therapeutic puncture of joints:
- Blood, exudate, pus in the joint cavity;
- Adhesions in the joint with fibrous adhesions;
- The need to administer novocaine in order to reduce the dislocation;
- Deforming arthrosis, the treatment of which requires the introduction of corticosteroids.
Intra-articular puncture with laboratory testing is performed to diagnose joint inflammation and identify connective tissue damage. Joint puncture makes it possible to detect the disease at an early stage, when it has not yet manifested itself and the inflammation does not cause concern to the person. Examination of the fluid contained in the joint gives an idea of the nature of the disease. A diagnostic puncture can identify pathological processes in the joints, such as injuries and chronic inflammation of the joints, infections.
The puncture is a minimally invasive procedure, performed using a syringe with a special needle. The doctor pierces the skin with a needle, takes fluid from the joint cavity and sends the material to the laboratory for testing. The procedure is practically painless, in some cases it is carried out even without anesthesia; unpleasant sensations are possible only when the needle is inserted. Sometimes, when performing a puncture, the doctor not only sucks out the fluid from the cavity, but also injects contrast agents or air into the joint. This manipulation allows you to determine ligament or meniscal tears and the extent of their damage.
Baker's cyst of the knee
The knee joint is one of the most complex in structure in the human body. He probably experiences the greatest physical stress. This is why knee joint diseases are most common. Baker's cyst of the knee joint is one of these pathologies, which is caused by inflammation of the joint.
The disease is characterized by pain in the knee that occurs when the limb is loaded, discomfort in the knee fossa. The advanced form is characterized by swelling of the joint, limited mobility, and partial deformation. That is why diagnosis and treatment of pathology should begin immediately.
Order of conduct
The manipulation is performed in a sterile operating room. Typically, joint puncture consists of the following steps:
- examination by a doctor and identification of contraindications;
- placing the patient on the operating table;
- antiseptic treatment of the puncture area;
- administration of anesthetic;
- performing a puncture;
- antibacterial treatment of the needle insertion site;
- applying a sterile napkin or bandage.
Still don’t know where to have a knee puncture in Nizhny Novgorod? Contact our medical center. Qualified doctors of the highest category will perform diagnostic and therapeutic arthrocentesis. We work with patients in mind.
Causes of Baker's cyst development
Most often, the disease develops due to metabolic-dystrophic or inflammatory processes that occur in the knee joint. Baker's cyst is caused by pathologies such as osteoarthritis, arthrosis, rheumatoid arthritis, but other options are also possible.
The main causes of Baker's cyst:
- Inflammatory processes in the knee joint.
- Pathological changes in the menisci.
- Mechanical damage to the knee.
- Excessive physical activity.
- Problems with cartilage, their gradual destruction.
Diseases leading to the formation of Baker's cyst:
- Rheumatoid arthritis.
- Psoriatic arthritis.
- Knee injuries.
- Osteoarthritis.
- Osteoarthritis.
- Metabolic disorders with joint damage (chondrocalcinosis, gout, etc.).
- Reactive arthritis, complicating some infectious diseases (tuberculosis, enterocolitis of various etiologies, respiratory tract infections, urogenital infections, Lyme disease, etc.).
Regardless of what exactly caused the pathological process to start, this causes increased production of synovial fluid, which fills the tendon bursa, which is why a cyst is formed.
A Baker's cyst can also occur due to mechanical damage to the knee.
Concept and types
Arthrocentesis is the puncture of a joint with a special needle. Depending on the purpose of the puncture, there are 2 types of puncture:
- Diagnostic. During the procedure, samples of joint fluid are taken. This allows you to identify traces of pus, blood, infections and specific proteins. The procedure also helps to detect atypical cells and other pathologies.
- Therapeutic. Performed to eliminate pathological contents from the joint. This puncture is also prescribed for local administration of medications.
Please note: therapeutic puncture of the hip joint (knee, shoulder, etc.) is performed several times. The duration of the course depends on the effectiveness of therapy and the complexity of the lesion.
Baker's cyst symptoms
Most often, patients develop a single cyst on one limb, but other variations occur when both legs are affected or multiple formations appear. At first, Baker's cyst practically does not manifest itself at all, but gradually its size increases from two to fifteen millimeters.
As it increases, the following symptoms appear:
- There are difficulties in bending and straightening the knee.
- Gradually a dense formation forms.
- Its palpation can lead to pain.
- Over time, the cyst begins to cause pain, even if it is stationary, and with movement these sensations intensify significantly.
- When the cyst affects the nerve endings, there may be numbness in the limb, goosebumps or a tingling feeling in the foot.
- Sometimes there is aching in the calf muscles.
Baker's cysts in children most often appear against the background of injuries, including knee bruises and various sprains that also affect the meniscus. Typically, pathologies develop between the ages of four and seven years, but few people go to the doctor, since it tends to go away on its own.
How is it carried out?
The technique of performing such a surgical intervention as puncture of the knee joint is very simple, which is explained by the anatomical structure and topographic location of the knee. The topography of the joint makes the procedure easier. According to anatomy, the patella is displaced slightly forward. During surgery, the patient assumes a supine position, and a soft cushion is placed under his knees.
The step-by-step operation includes the following manipulations:
- The puncture area is treated with an antiseptic solution of iodine and alcohol. To ensure that the patient does not feel pain during the operation, the site of the future puncture is anesthetized.
- If a puncture is performed to administer oxygen, a thin needle with a diameter of no more than a millimeter is used. If it is necessary to suction the pus, use a needle with a size of 2 millimeters.
- To prevent infection, the skin at the puncture site is moved to the side.
- The needle advances slowly and rather heavily until it reaches the joint capsule. After piercing the joint capsule, the needle is moved no more than 3 millimeters to prevent damage to the cartilage.
- To remove the liquid, use a special syringe. After completing the operation, the puncture point is disinfected, after which a sterile bandage is applied. The bandage is not removed until the joint is fully restored at home.
During the rehabilitation period, the patient's condition is monitored by the attending physician. If the operation is performed correctly and all restoration requirements are met, a repeat procedure will not be required, and the positive effect will not be long in coming. The main thing is not to deviate from the doctor’s recommendations, and then the puncture area will not even swell.
During rehabilitation, you need to regularly visit the doctor for routine examinations. After the operation there are no scars, so you don’t have to think about plastic surgery.
The average price of the procedure in Moscow is 1,600 rubles.
How is Baker's cyst punctured under ultrasound guidance at the Paracelsus Medical Center?
During the procedure, an orthopedic traumatologist evacuates synovial fluid from the joint, which is sent to the laboratory.
The next step, as prescribed by the doctor, may be the introduction of medications into the joint cavity, such as steroidal anti-inflammatory substances (hormones), chondroprotectors (drugs for cartilage restoration), synovial fluid prostheses (for example, hyaluronic acid preparations).
Ultrasound navigation during puncture:
- helps to assess the location of the puncture needle (i.e., the needle is strictly in the joint cavity and no vessels or nerves pass along its path), the residual volume of synovial fluid in the joint;
- controls the administration of the medicinal substance, i.e. the doctor is sure that he is injecting the drug into the joint cavity, and not into the soft tissues (periarticular). This is important, since periarticular administration may reduce the effectiveness of drugs.
Baker's cyst puncture of the knee joint is performed by an experienced orthopedic traumatologist. Ultrasound control is carried out by an Ultrasound Diagnostics doctor.
The procedure is performed on an outpatient basis; no anesthesia is required (the puncture is no more painful than intravenous injections).
Punctures can be performed on patients of any age. Immediately after, the patient can perform his usual work and lead a normal lifestyle.
Which joints are punctured?
Puncture is performed on almost all joints: phalangeal, hip, knee, shoulder, elbow, etc.
The puncture technique is almost the same for all joints, the only difference is the injection site. This manipulation requires the professionalism of a doctor, since it is important not to damage the surrounding tissues or touch the bone. The puncture site is treated with an antiseptic, anesthesia is given, and then a puncture is performed.
A diagnostic puncture of the shoulder joint is performed if inflammation of the joints is suspected.
The purpose of puncture of the elbow joint is to diagnose rheumatic lesions and joint injuries. A puncture of the wrist joint is performed to determine inflammation of the joints caused by connective tissue diseases. The puncture area is the back of the hand, between the tendons of the index finger and the thumb and forefinger.
The purpose of a knee is to confirm or refute the presence of rheumatoid arthritis.
Diagnostic puncture of the hip joints can detect gout.
small joints of the hand will help diagnose connective tissue diseases (rheumatoid arthritis, gout, systemic lupus erythematosus) .
Punctures of the ankle joint and small joints of the foot are performed if connective tissue diseases that cause inflammation of the joints are suspected.