Equine Health Update Issue 2 Volume 19 - Page 13

EQUINE | Abstracts Abstract Intrasynovial access to the equine coxofemoral joint (CFJ) is inherently challenging. Blind injection tech- niques rely upon inconsistently palpable landmarks, and ultrasound guidance requires expertise for needle placement into the coxofemoral articulation. Aspiration is recommended to confirm intrasynovial placement and avoid sciatic nerve anesthesia. The aim of this obser- vational, descriptive, retrospective study was to evalu- ate the feasibility for an alternative ultrasound-guided approach in horses with cranioventral distention of the CFJ identified during pelvic ultrasound. Thirteen horses with cranioventral CFJ distention, including 12 with se- vere pathology, were recruited from 2009 to 2014. Seven were excluded as they were not injected or underwent ultrasound-guided injection using a dorsal approach. The remaining six horses underwent a total of nine in- jections into the cranioventral recess. With the exception of one foal, all were aged horses (15- 29 years) of varying breeds and uses, with prominent lameness due to subluxation (three), luxation (two), and severe osteoarthritis (one). The cranioventral recess was imaged adjacent to the proximal femur using a low- frequency curvilinear transducer placed ventral to the cranial joint margins. Using aseptic technique, spinal needles were placed cranial to the transducer and ad- vanced caudomedially into the distended cranioventral recess. Synovial fluid was retrieved in all cases with one needle placement. Findings indicated that, when dis- tended, ultrasound-guided access to the cranioventral CFJ recess is a feasible alternative approach and may re- duce the potential for extra-synovial placement. Disten- tion in this sample of horses was accompanied by severe pathology, also supporting the use of this approach for therapeutic interventions. ____________________________________________ Vet Radiol Ultrasound. 2015 Sep-Oct; ABNORMAL IMAGING FINDINGS OF THE FEMO- RAL THIRD TROCHANTER IN 20 HORSES. Shields GE, Whitcomb MB, Vaughan B, Wisner ER. Abstract Injuries involving the femoral third trochanter are an uncommon but important source of equine lameness; however, clinical localization can be challenging. The purpose of this retrospective study was to describe ul- trasonographic and scintigraphic findings in a group of horses with presumed third trochanter injury. Medi- cal records of an equine referral hospital were searched from 2004-2014, and 20 horses met the inclusion cri- teria. Lesions consistent with third trochanter fracture were identified with ultrasound in 14/20 horses. Onset of lameness was acute (11), insidious (2), or unknown (1). All but one horse was lame at presentation, ranging from Grade 2-4/5. Ultrasound was the primary diagnos- tic modality in 5/14 horses with fragmentation, while scintigraphic findings of intense (3), moderate (5), and mild (1) increased radiopharmaceutical uptake (IRU) prompted ultrasonographic examinations in 9/14 frac- tured horses. A nondisplaced fracture was suspected in an additional horse with intense IRU and negative ultra- sound findings. In the remaining five horses, imaging findings included only mild IRU. Lameness was localized to other regions in these cases. Six of 12 fractured horses with available outcome data were returned to function after a prolonged rehabilitation of 8-18 months. Scin- tigraphic findings helped to direct focused ultrasound exams in the majority of fracture cases. Horses with evidence of third trochanter fracture had similar clinical characteristics to that reported for pelvic fractures and authors therefore recommend ultrasonographic exami- nation of both regions, especially when scintigraphy is unavailable. Prognosis for return to function in horses of the current study was less favorable than previously reported. • Volume 19 no 2 • June 2017 • 13