Arthrocentesis: shoulder

Indications

General arthrocentesis indications

• Suspicion of septic arthritis
• Suspicion of crystal induced arthritis
• Evaluation of therapeutic response for septic arthritis
• Unexplained arthritis with synovial effusion
• Evaluation of joint capsule integrity if overlying laceration
• Relative: therapeutic (decrease intra-articular pressure, injection of anesthetics/steroids)

Contraindications

General arthrocentesis contraindications

• No absolute contraindications for diagnostic arthrocentesis
• Do not inject steroids into a joint that you suspect is already infected
• Relative Contraindications:
  • Overlying cellulitis
  • Coagulopathy
  • Joint prosthesis (refer to ortho)