Safety of Arthrocentesis and Joint Injection in Patients Receiving Anticoagulation at Therapeutic Levels

Spontaneous elbow hemarthrosis identified by point-of-care ultrasound

“…Arthrocentesis is typically considered safe in patients with a therapeutic INR, but there is little data to support the safety of aspiration in patients with INR >5 [7,12]. …”

“…Point-of-care ultrasound can facilitate the timely diagnosis and treatment of patients with musculoskeletal complaints, and may be superior to clinical examination or radiographs for detecting joint effusions [2-4]. Increasing evidence supports the use of ultrasound in the emergency department for the diagnosis and treatment of fractures, tendon injuries, joint effusions, and soft tissue infections [5-7]. We report a novel case of a man with a spontaneous elbow hemarthrosis in the setting of a warfarin-induced coagulopathy.…”

Complications in Musculoskeletal Intervention: Important Considerations

“…Ahmed and Gertner reported no difference in bleeding complications in patients with international normalized ratio (INR) above or below 2.0 receiving arthrocentesis and joint injection. 2 Besides an understanding of the anatomy, a review of each patient's comorbidities, medications, and coagulation parameters is imperative prior to proceeding with a procedure. Certain conditions such as cirrhosis, chronic liver disease, vitamin K deficiency, and shock or sepsis with disseminated intravascular coagulation can increase the risk of bleeding.…”

Arthrose — Was der Internist wissen sollte

“…Letztere sollten maximal 4-mal jährlich erfolgen. Sie können auch mit relativ geringem Risiko unter oraler Antikoagulation durchgeführt werden [24]. Andia et al [25] und Pourcho et al [29] haben kürzlich die Evidenz für PRP bei der aktivierten Arthrose zusammengetragen.…”