Joint Injection

Diagnosis of Joint Pain and Swelling

There are many causes of joint pain and swelling. Infections (both bacterial and viral), degenerative changes, fractures, bleeding into the joint from trauma, inflammatory arthritis such as gout or rheumatoid arthritis, and mechanical irritation such as from a torn meniscus can all cause joint pain and swelling. Removing fluid from the joint can be very helpful in making the diagnosis. The physician can tell if blood, pus, or normal straw-colored fluid is present in the joint. Further analysis of the fluid with culture and microscopic examination of the types of cells in the fluid can help determine if bleeding, infection, or inflammatory arthritis is present. It is essential to determine the cause of joint pain and swelling in order to formulate an appropriate treatment plan.

Injection of a contrast material into a joint followed by computed tomography (CT) or magnetic resonance imaging (MRI) can help detect subtle injuries as well as more clearly identify the anatomic structures. This can help improve the sensitivity of these procedures as diagnostic tools.

Reduction of Inflammation and Pain

Once it is determined that joint injection is the appropriate course of action, medications can be injected into the joint to help reduce the inflammation and pain. Injected medications can be helpful when oral medications cannot be used or are not effective. It is a general rule in sports medicine that a joint should not be injected solely for the purpose of allowing an athlete to return to participation if there is a risk that further damage to the joint may occur.

Improvement of Joint Function

Sometimes, injections are given specifically to help with the joint function. Reduction of inflammation is certainly one way to achieve this, but there are also medications that when injected into a joint are believed to help with the healing of damaged articular cartilage. These can help improve joint function by decreasing pain.