General

Synonym/Acronym:
N/A

Rationale
To obtain direct visualization of a specific joint to assist in diagnosis of joint injury or disease and assessment of response to treatment.

Patient Preparation
There are no activity restrictions unless by medical direction. Food and fluids will be restricted to reduce aspiration risk from nausea and vomiting related to anesthesia during the procedure. Some institutions may allow clear liquids up to 2 hr prior to receiving regional anesthesia, or sedation/analgesia (monitored anesthesia). Those having general anesthesia are usually required to be NPO (nothing by mouth) at midnight the night before the procedure. The American Society of Anesthesiologists has fasting guidelines for risk levels according to patient status. More information can be located at www.asahq.org.

Patients on beta blockers before the surgical procedure should be instructed to take their medication, as ordered, during the perioperative period.

Regarding the patient’s risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken. Protocols may vary among facilities.

Advice and education regarding pre- and postprocedural skin care is recommended; increased patient engagement levels are linked to decreased risk for a health-care-associated infection.

Normal Findings

• Normal muscle, ligament, cartilage, synovial, and tendon structures of the joint, which is lined with a smooth, finely vascularized synovial membrane. The normal appearance of the cable-like ligaments and tendons visible in joints is smooth and silvery; the cartilage appears smooth and white.

Critical Findings and Potential Interventions
N/A