A PROSPECTIVE-STUDY OF THE SAFETY OF JOINT AND SOFT-TISSUE ASPIRATIONS AND INJECTIONS IN PATIENTS TAKING WARFARIN SODIUM

Objective. To determine the safety of joint or soft tissue aspirations and injections in patients taking warfarin sodium, Methods. The outco me of 32 joint or soft tissue aspirations or injections in patients re ceiving stable doses of warfarin sodium was assessed through a standar dized interview 4 weeks after the procedure, The primary outcome measu re was significant joint or soft tissue hemorrhage, ascertained by pat ient-reported increases in swelling or warmth at the procedure site, R esults, None of 32 procedures was complicated by joint or soft tissue hemorrhage reported by the patients, yielding, by the ''rule of threes ,'' a risk of significant hemorrhage of <10% (with 95% certainty). Dia gnostic information was obtained for 53% of aspirated sites (8 of 15) and therapeutic benefit was noted in 74% of corticosteroid-injected si tes (17 of 23). Conclusion. Joint or soft tissue injections and aspira tions in selected patients taking warfarin sodium are associated with a low risk of hemorrhage and are often of diagnostic or therapeutic va lue.