Dr. M.J. Bazos, Patient Handout


All physicians must comply with the Occupational Safety and Health Administration's (OSHA) "Standard on Occupational Exposure to Bloodborne Pathogens" published in the Federal Register on December 6, 1991. This standard covers employees in all health care facilities with one or more employees, including hospitals, clinics, dentists' and physicians' offices.

To reduce the risk of transmitting infection between patients and health care workers, the Council on Rheumatologic Care (CORC) recommends the following safety guidelines for performing arthrocentesis:

1. The physician performing arthrocentesis or injection of joints, bursae, or triggerpoints should be gloved. If the skin of the procedure area is prepped and the needles and syringes are handled with usual sterile technique, the gloves need not be sterile. Gloves should remain on the hands until the completion of the procedure, the securing of the synovial fluid specimen in appropriate containers, and disposal of all materials contaminated by blood or synovial fluid into appropriate sharps and biohazard containers. Hand washing should follow the procedure.

2. Nurses or assistants preparing syringes or handling other material to be used in a joint procedure should wear gloves.

3. Attendants and laboratory personnel handling synovial fluid, containers with synovial fluid, or gauze or other materials contaminated by blood or synovial fluid should wear gloves and should subsequently wash hands. If the nurse or other assistant during a joint procedure follows sterile technique and is not asked to handle synovial fluid specimens or gauze contaminated with blood or synovial fluid and does not otherwise come in contact with the patient, then this person need not wear gloves.

4. Since the chances that synovial fluid or blood will splash or splatter and potentially soil garments or skin are so remote, the use of masks, goggles, and gowns are not necessary during joint aspirations and injections. However, physicians and assistants participating in joint procedures should exercise judgement and should appropriately use gloves, gowns, masks, and goggles if there is any reasonable likelihood of unusual exposure to a patient's synovial fluid or blood during a procedure.

5. Proper disposal into sharps and biohazard containers should be made for all needles and syringes, gloves, gauze pads, and any other material potentially contaminated with synovial fluid or blood. All needles coming in contact with the patient's skin or other tissues should be placed in disposable biohazard containers designed for sharps directly by the physician doing the procedure, without any transfer of such syringes or needles to the assistant. Sheering, breaking, or recapping of contaminated needles should not be done unless required by a specific medical procedure.