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.
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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 •
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