IR( interventional radiology)-4

Arthrocentesis/joint aspiration/steroid injection:-

Arthocentesis

Joint aspiration is a procedure where the fluid is drained out from a joint with the help of needle or syringe for laboratory analysis. It is helpful to determine the cause of joint swelling or arthritis.

20600 Arthrocentesis, aspiration and/or injection; small joint or bursa (eg, fingers, toes)
20605 Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)
20610 Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)

1. Sample Report:

Findings, right hip injection of steroids and bupivacaine performed under fluoroscopic guidance.
Signed informed consent obtained prior to the procedure. Time out performed prior to the procedure, documented by technologist per Skin was marked under x-ray guidance. Betadine cleansing performed with sterile drapes applied.Lidocaine anesthesia anesthetize the skin and subcutaneous tissues.Utilizing fluoroscopic guidance,20-gauge spinal needle placed in the joint space at the junction of the femoral head and neck. 80 mg of Depo-Medrol with 2 mL of bupivacaine administered without incident into the joint space with low resistance. Patient tolerated procedure well. Needle removed and hemostasis obtained.No immediate complications.

Impression: Successful injection of Depo-Medrol and bupivacaine right hip under fluoroscopic guidance.

2. Sample Report:

ASPIRATION JOINT/LRG*

PROCEDURE- Fluoroscopy guided knee joint aspiration

HISTORY- The patient is an 84-year-old referred by Dr Tejani for evaluation of the right knee for fluoroscopy-guided aspiration.

DISCUSSION- The procedure including risks and benefits were discussed with the patient. Both written and verbal consent was obtained. Fluoroscopic guidance was used to localize a suitable site for
injection. This area was marked, prepped, and draped using routine sterile technique. 1% lidocaine was used as local anaesthesia. A 20-gauge needle was advanced into the knee joint using fluoroscopic guidance. The knee was then aspirated and approximately 67 mL of yellow cloudy fluid was removed. The fluid will be sent for diagnostic studies as requested. The needle was removed and a sterile bandage was applied over this site. The patient tolerated the procedure well. There were no immediate
complications. Postprocedural instructions were given. The patient left the department in a stable condition.

IMPRESSION- Successful fluoroscopy-guided right knee aspiration as described above.