Accuracy of ultrasound-guided intra-articular injection of cervical facet joints in horses: a cadaveric study.
Abstract: Intra-articular facet joint injection is an established diagnostic procedure in human medicine but there are no reports on its reliability in equine practice. Objective: To investigate the accuracy of ultrasound-guided intra-articular injections of the cervical facet joints and to estimate factors influencing the accuracy. Methods: Sixty injections with blue dye were performed on the facet joints between 2nd and 7th cervical vertebra (C2-C7) on horses subjected to euthanasia for nonorthopaedic reasons. The facet joints were subsequently dissected to verify accuracy of deposition. Results: Seventy-two percent of the injections were found to be intra-articular, 17% were intracapsular and a total of 98% were within 1 mm of the joint capsule. There was a marked effect of gained experience (P < 0.01), but not of other factors tested. Conclusions: The results of the present study do not translate directly to injections performed in live horses, but they indicate that the method can be applied as a diagnostic as well as therapeutic procedure in C2 to C7 and that is advisable to practise injections on cadaver specimens before applying the technique.
Publication Date: 2003-12-03 PubMed ID: 14649356DOI: 10.2746/042516403775696366Google Scholar: Lookup
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- Journal Article
Summary
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The study aimed to ascertain the accuracy of ultrasound-guided intra-articular injections on the cervical facet joints of horses, as well as to identify any factors that might impact this accuracy. This technique is well established in human medicine, but there has been little research regarding its use in equine medicine.
Research Methodology
- A total of sixty injections were carried out on the facet joints of horses. The horses used were not specifically for this study, but were horses that had been euthanized due to reasons unrelated to orthopaedic conditions.
- The facet joints targeted were those located between the 2nd and 7th cervical vertebrae (C2-C7).
- For clarity and ease of identifying the accuracy of the injections, they were performed using blue dye.
- After the injections, the respective facet joints were dissected to verify where exactly the dye (and therefore the injections) had landed.
Research Findings
- Post-dissection, it was observed that 72% of the injections had accurately reached the intra-articular space.
- 17% of the injections turned out to be intracapsular, meaning the injection site was within the joint capsule but not actually within the joint space itself.
- Interestingly, almost all the injections (98%) were within 1 mm of the joint capsule, indicating a high degree of accuracy overall.
- The study also found a remarkable correlation between the accuracy of the injections and the increase in experience of the person performing the injection (P < 0.01).
- The other factors evaluated in the study did not show significant effect on the injection accuracy.
Conclusions
- While the results of the study cannot be directly applied to live horses due to the difference in tissue conditions between live horses and cadavers, the study still indicates that ultrasound-guided intra-articular injections could potentially be utilized effectively in equine medicine, both for diagnostic and therapeutic purposes.
- The researchers also concluded that it is advisable for practitioners to first practice these injections on cadaver specimens before applying the technique on live horses to increase accuracy and minimize harm.
Cite This Article
APA
Nielsen JV, Berg LC, Thoefnert MB, Thomsen PD.
(2003).
Accuracy of ultrasound-guided intra-articular injection of cervical facet joints in horses: a cadaveric study.
Equine Vet J, 35(7), 657-661.
https://doi.org/10.2746/042516403775696366 Publication
Researcher Affiliations
- Department of Anatomy and Physiology, The Royal Veterinary and Agricultural University of Copenhagen, Bülowsvej 17, DK-1870 Frederiksberg C, Denmark.
MeSH Terms
- Animals
- Bromphenol Blue / administration & dosage
- Cadaver
- Cervical Vertebrae / diagnostic imaging
- Cervical Vertebrae / pathology
- Coloring Agents / administration & dosage
- Horse Diseases / diagnosis
- Horse Diseases / diagnostic imaging
- Horses
- Injections, Intra-Articular / methods
- Injections, Intra-Articular / standards
- Injections, Intra-Articular / veterinary
- Joint Diseases / diagnosis
- Joint Diseases / diagnostic imaging
- Joint Diseases / veterinary
- Sensitivity and Specificity
- Ultrasonography
Citations
This article has been cited 8 times.- Nocera I, Di Franco C, Sorvillo B, Aliboni B, Bucchioni E, Sgorbini M, Sala G, Citi S. Evaluation of the feasibility of equine in-vivo ultrasound technique for the medial branch of the dorsal ramus of the cervical spinal nerves. Vet Q 2024 Dec;44(1):1-5.
- Davidson EJ, Stefanovski D, Slack J, Manzi TJ. Ultrasound-guided caudal cervical articular process arthrocentesis is accurate in live horses with and without arthropathy. Equine Vet J 2025 Mar;57(2):398-405.
- Fotouh AA, Hamdy M, Ali F, Mohamed EF, Allam A, Hassan WA, Elsaman A, El-Najjar A, Amer MA, Mosad D, Tharwat S, El Bakry SA, Saleh H, Zaghloul A, Mahmoud M, Mohammed RHA, El-Saadany H, Fathi HM, Hammam N, Raafat HA, Moharram AN, Gheita TA. The Emerging Era of Interventional Imaging in Rheumatology: An Overview During the Coronavirus Disease-2019 (COVID-19) Pandemic. Open Access Rheumatol 2022;14:43-56.
- Johnson JP, Vinardell T, David F. Ultrasound-guided injections of the equine head and neck: review and expert opinion. J Equine Sci 2021 Dec;32(4):103-115.
- Story MR, Haussler KK, Nout-Lomas YS, Aboellail TA, Kawcak CE, Barrett MF, Frisbie DD, McIlwraith CW. Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment. Animals (Basel) 2021 Feb 6;11(2).
- Touzot-Jourde G, Geffroy O, Tallaj A, Gauthier O, Denoix JM. Ultrasonography-Guided Perineural Injection of the Ramus ventralis of the 7 and 8th Cervical Nerves in Horses: A Cadaveric Descriptive Pilot Study. Front Vet Sci 2020;7:102.
- Beaulieu A, Linden AZ, Phillips J, Arroyo LG, Koenig J, Monteith G. Various 3D printed materials mimic bone ultrasonographically: 3D printed models of the equine cervical articular process joints as a simulator for ultrasound guided intra-articular injections. PLoS One 2019;14(8):e0220332.
- Shearer TR, Kinsley MA, Pease AP, Patterson JS. Development of a minimally invasive approach to equine cervical articular facet joints for placement of an ND:YAG LASER. Can Vet J 2017 Nov;58(11):1181-1186.
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