possible open joint: how much do I infuse?

RAGING HYPOTHETICAL:
--patient arrives with wound around the knee
--want to inject saline in the joint capsule to see if it is open (if it leaks)
--how much saline do I put in there?


Keese et al. The Accuracy of the Saline Load Test in the Diagnosis of Traumatic Knee Arthrotomies. J. Orthop Trauma. 21;7. Aug 2007.

--study of 30 patients undergoing arthroscopy


--after arthroscopy hole was made each knee was injected with saline and measure how much it took until extravasation was seen.


--50ml of saline gave 46% sensitivity
--194ml of saline gave 95% sensitivity. 




FOOD FOR THOUGHT:
--standard 50ml injection not great sensitivity in this small study
--200cc NS seemed to do the trick




Submitted by T. Boyd.




Reference(s): article, picture