THEORETICAL AND TECHNICAL BASIS OF TESTING
The test consists in introducing a special metal pipe with an optical system inside the pond, i.e. arthroscopy and direct viewing (colonoscopy) of intra-articular structures. The field of view in the arthroscope is illuminated by means of glass fibers (so-called cold lighting).
Arthroscopy can be divided into a diagnostic one, when the type of pathology inside the joint is determined, and when the diagnosis is determined, special surgical tools are inserted through the skin into the joint and some therapeutic procedures are performed under the control of the image seen in the arthroscope. Often diagnostic arthroscopy is the initial stage of surgical arthroscopy.
WHY ARE THE STUDY?
Arthroscopic examination, thanks to the possibility of assessing joint structures “from the inside, allows to specify the diagnosis and determine the proper treatment. In addition, arthroscopy allows for intra-articular repair operations, eg removal of the damaged part of the meniscus or excision of the overgrowing synovium, which often allows to avoid the surgical opening of the joint and shorten the period of return to full physical function after the procedure. The most developed and most popular is knee joint arthroscopy and scapulo-brachial joint. Arthroscopy of the ankle, elbow and hip joints as well as the microartroscopy of the wrist and hand joints are increasingly performed.
INDICATIONS FOR THE TEST
– Joint injuries.
– Instability of movements in the joints.
– Intra-articular fractures.
– Rheumatoid arthritis (RA).
– Degenerative changes.
– Presence of foreign bodies in the pond.
– Tumors within the joints.
The examination is carried out at the request of a doctor
Radiological examinations in projections accepted for the diagnosis of individual joints, sometimes electromagnetic resonance (MRI of joints and bones). See also “Pre-anesthetic examination in” Anesthesiological methods in diagnostic tests in the chapter “Anesthesia methods.
METHOD OF PREPARING FOR TEST
See “Method of preparation for anesthesia in” Anesthetic methods in diagnostic tests in the chapter “Anesthesia methods. The test is performed under local anesthesia or general anesthesia. In children, the test is performed under general anesthesia
DESCRIPTION OF THE TEST
The test is carried out in the operating room. The patient is laid in a lying position, convenient for colonoscopy, eg when the knee joint is seen in the knee, the limb is slightly raised and bent in the joint. The surface of the skin around the examined joint is covered with surgical drapes, while the skin at the site of the examination is washed with a disinfectant (eg iodine). If it is possible, a tourniquet is put above the test joint – so-called Esmarch’s bandage to induce ischemia and reduce possible bleeding during colonoscopy. In order to insert the arthroscope into the joint small incisions of the skin and subcutaneous tissues are made in strictly defined places. For each joint, anatomical points are marked through which the optical system and arthroscopic tools can be safely inserted. A suitable tube or tubing is also inserted into the test pond, which is fed with gas (carbon dioxide) or aqueous solution (0.9% sodium chloride solution) during the test (Fig.9-6).
Depending on the needs, the gas or aqueous solution is discharged through a suitable channel with a valve in the arthroscope. Filling the pond with an aqueous solution or gas makes it easier to view its interior through the optical system of the arthroscope. Currently, special video tracks are used that allow transferring arthroscopic image to a television monitor and recording the course of the study on a video tape. The study evaluates joint structures, i.e. joint cartilage, synovial membrane, ligaments, tendons of muscles passing through the joint, meniscus and other structures characteristic of the examined joint. After seeing the “interior of the pond, the investigator can perform repair treatments inside the pond. For this purpose, he uses special tools introduced to the pond regardless of the arthroscope. See also “Description of anesthesia methods in” Anesthetic methods in diagnostic tests in the chapter “Anesthesia methods. The test result is provided in the form of a description, sometimes accompanied by a video tape.
The study lasts up to several dozen minutes
INFORMATION WHICH YOU SHOULD REPORT AN EXECUTIVE TEST
– Occurring ailments about the joint, their duration, symptoms and location within the joint.
– Radiological results of the joint.
HOW CAN I SAVE AFTER THE TEST?
According to individual recommendations of the doctor performing the test. See also How should you behave after anesthesia? “Anesthesiological methods in diagnostic tests in the chapter Anesthesia methods.
POSSIBLE COMPLICATIONS AFTER A RESEARCH
The most common complications may be a hematoma of the joint, exudation in the joint; very rarely purulent arthritis can occur.
See also Possible complications after anesthesia “Anesthetic methods in diagnostic tests in the chapter” Anesthesia methods. If necessary, the test can be repeated periodically. It is performed in patients of all ages as well as in pregnant women.
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