Anatomy of the ankle
The ankle joint is found between the tibia, fibula, and talus. To perform an arthrocentesis of the ankle, we will use the medial approach to access the ankle joint between the medial malleolus, the talus, and the tibialis anterior tendon (ankle dorsiflexor).
Ideal positioning for arthrocentesis of the ankle
For an ankle arthrocentesis, or ankle tap, you need to properly position your patient:
- Patient is laying down
- Legs are straight
- Affected foot flexed slightly forward
Once the patient is positioned, you will stand in front of the affected foot to perform the arthrocentesis procedure on the affected ankle joint.
How to perform arthrocentesis of the ankle
The arthrocentesis procedure requires six simple steps to ensure a safe, clean, and painless ankle tap:
- Direct a 20 gauge (G) needle to the inside of the tibialis anterior tendon and below the medial malleolus.
- At a 45° angle, insert the needle 2–3 cm.
- Aspirate as soon as your needle enters the skin.
- Stop advancing the needle when you see fluid.
- Extract the joint fluid.
- Take the needle out and apply a bandage.
So there you have it, a summary for performing an ankle arthrocentesis. Great work!
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- Roberts, J. 2019. “Arthrocentesis”. In: Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. 7th edition. Philadelphia: Elsevier.