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Joint Injections (Joint Aspirations)

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Joint injections and joint aspirations may be done as part of a treatment plan for inflammatory joint conditions. Inflammatory joint conditions include rheumatoid arthritis, psoriatic arthritis, gout, tendinitis, bursitis and, osteoarthritis.

What Is a Joint Injection and Joint Aspiration?

A joint injection is using a needle to inject a medication directly into a joint, such as a knee. Medications can include corticosteroids (sometimes called “cortisone”) and hyaluronic acid. Joint injections can decrease pain, inflammation, swelling, and stiffness. Joint injections can also decrease the build-up of fluid and cells in a joint. The positive effects of joint injections are not permanent. Improvements from a joint injection usually last a few months before wearing off. In some milder conditions, joint injections may produce longer periods of disease control.

A joint aspiration is using a needle to remove joint fluid, sometimes before a medication is injected into the joint. Removing joint fluid can provide pain relief and improve mobility. Fluid from a joint aspiration can be examined by a healthcare provider or sent for laboratory analysis. Lab analysis can include a cell count (the number of white or red blood cells), crystal analysis (to see if one has gout or calcium pyrophosphate deposition), or culture (to see if an infection is present inside the joint).

Possible Risks or Side Effects

Occasional side effects of joint injections include allergic reactions to the medications injected into joints. A person may also be allergic to tape or the disinfectant used to clean the skin before the injection. Infections are very rare. Another uncommon complication is a post-injection flare – joint swelling and pain several hours after the injection. A post-injection flare usually goes away in a few days. It is not known if joint damage may be related to having corticosteroid injections too often. It is generally not encouraged to get repeated and numerous injections into the same joint or site. Other complications may include depigmentation (a whitening of the skin), local fat atrophy (thinning of the skin) at the injection site, and rupture of a tendon near the injection site.

Joint injections should not be given if an infection is present inside or around a joint. Joint injections should also not be given if someone has a serious allergy to one or more of the medications that are injected into a joint. If an infection is suspected, it is important to do a joint aspiration to gather fluid for analysis. Be sure to let your healthcare provider know if you have had an allergic reaction to a steroid medication, a sterilizing soap (such as betadine or chlorhexidine), lidocaine, tape, or adhesives.

Updated February 2024 by Laura Ray, MLS, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This patient information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis, and treatment of a medical or health condition.

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