Comparing the clinical success rate of the dorsolateral approach to the medial approach for injection of the centrodistal joint in the horse

Intra-articular injection in the hind limb joints of dromedary camels (Camelus dromedarius) using anatomical and arthrographic-guided landmarks

Background and Aim:

A healthy joint is an important structure for the proper movement of the camel limb. Intra-articular (IA) injection is frequently used in veterinary practice for diagnostic and therapeutic purposes of joint injuries. Thus, the current study aimed to describe the injection of the hindlimb joints in dromedary camels based on the anatomical and arthrographic-guided landmarks.

Materials and Methods:

Eighteen orthopedically sound adult camels (mean±standard deviation age: 78±12 months) of both sexes were included in this study. Three camels were euthanized to identify anatomical features in the hindlimb joints and related structures. IA injections were performed in the hindlimbs of 5 camel cadavers to evaluate the optimal IA injection site, which was confirmed by arthrography. The optimized IA injection technique was applied in 10 live camels and confirmed by arthrocentesis and arthrography. For each joint, injection criteria (number of attempts, difficulty of injection, and successful injection) were assessed, scored, and statistically compared to the other joints.

Results:

The summation of IA injection criteria scores was significantly higher (p<0.05) in the femorotibial, femoropatellar, tibiotarsal, fetlock, pastern, and coffin joints in comparison to the hip joint.

Conclusion:

Anatomical and arthrographic-guided techniques offer considerable advantages for the characterization of anatomical landmarks and selection of the appropriate IA injection site in the hindlimb in dromedary camels. Furthermore, a reference approach for camels was established that is different from the approach for cattle and horses.

Ultrasound-assisted injection of the centrodistal joint in the horse

BACKGROUND

Injection of the centrodistal (CD) joint in the horse is a commonly performed procedure for both diagnostic and therapeutic purposes. This procedure can be technically challenging, and while radiographic guidance has been previously used, ultrasound localised injection of the CD joint has not been described.

OBJECTIVES

The purpose of this study was to explore the feasibility of using ultrasound localisation to increase the accuracy of CD joint injection.

STUDY DESIGN

Experimental method assessment.

METHODS

One operator performed the ultrasound and injection of 24 CD joints in 12 sedated horses. The joints were injected with iohexol (2 ml), sterile saline (1.5 ml) and amikacin (0.5 ml). Dorsoplantar and dorsomedial plantarolateral radiographic projections were obtained immediately after injection to evaluate the presence of contrast material in the CD joint.

RESULTS

The CD joint was successfully injected in 17/24 joints, representing a 70.8% accuracy.

MAIN LIMITATIONS

The horses used in this study were from the University research herd, and not clinical cases. One investigator performed all the ultrasonography and CD joint injections.

CONCLUSIONS

The use of ultrasound localisation could improve success of CD joint injection as well as improve the learning curve of less experienced practitioners learning this procedure.