The elbow of a 78-year-old woman became swollen and painful within an hour - a typical history of haemarthrosis. Warfarin treatment with a high INR (3.9) was the predisposing factor. Ultrasonography shows a large, compressible collection of blood filling the joint cavity. Blood is more echogenic than synovial fluid. The skin is anaesthetized with lidocaine. A large needle is used to facilitate aspiration. Aspiration of haemarthrosis is always indicated because removing the blood alleviates pain and hastens the recovery of function. The most common site for a haemarthrosis is the knee, followed by the ankle.
Aspiration of haemarthrosis (elbow)