Joint aspiration and injection

Best Pract Res Clin Rheumatol. 2005 Jun;19(3):345-69. doi: 10.1016/j.berh.2005.01.009.


Joint aspiration/injection is an invaluable procedure for the diagnosis and treatment of joint disease. The knee is the commonest site to require aspiration although any non-axial joint is accessible for obtaining synovial fluid. Septic arthritis and crystal arthritis can be readily diagnosed by aspirating synovial fluid. Intra-articular injection of long-acting insoluble corticosteroids produces rapid resolution of inflammation in most injected joints and is a well established procedure in rheumatological practice. The technique involves only a knowledge of basic anatomy and should not be unduly painful for the patient. Provided sterile equipment and a sensible, aseptic approach are used it is a safe procedure. This chapter addresses the indications, technical principals, expected benefits and risks of intra-articular corticosteroid injection. The use of other intra-articular injections including osmic acid, radioisotopes and hyaluronic acid, which are less universally utilised than intra-articular corticosteroid, will also be addressed.

Publication types

  • Review

MeSH terms

  • Glucocorticoids / administration & dosage
  • Humans
  • Hyaluronic Acid / administration & dosage
  • Injections, Intra-Articular / methods*
  • Joint Diseases / diagnosis*
  • Joint Diseases / drug therapy*
  • Joints / pathology
  • Osmium Tetroxide / administration & dosage
  • Suction / methods*
  • Yttrium Radioisotopes


  • Glucocorticoids
  • Yttrium Radioisotopes
  • Hyaluronic Acid
  • Osmium Tetroxide