Experience is important for the proper performance of joint aspiration and injection procedures. Physicians skilled in arthrocentesis usually have had the opportunity to gain experience with a rheumatologist or other physician who performs many procedures. Each joint has different anatomic landmarks, and novice physicians may need to review a textbook for approaches to an unfamiliar joint. Although arthrocentesis is a simple technique with minimal risk, physicians should have assistance or supervision with their first attempts at any site. Family physicians wanting to perform arthrocentesis on deep joints, such as the hip or vertebral joints, should obtain extensive training in these higher risk procedures. Additional training in arthrocentesis is available from the American Academy of Family Physicians.
Although generally well tolerated, there are risks involved with a steroid injection. Infection and bleeding are risks with any injection. Though rare, a “flare” of increased pain after the injection can also occur. This flare generally subsides within 3 days. If this happens to you, call your doctor. Steroid injections can also raise your blood glucose level for a few days so if you have diabetes, you should discuss this potential risk with your doctor. There are other risks involved. For example, if you are on a blood thinner like warfarin, you may need to discontinue it prior to the injection.