An ultrasound-guided, tendon-sparing, lateral approach to injection of the navicular bursa.
Abstract: Navicular disease in the horse often requires injection of the navicular bursa. We have developed an ultrasound-guided, lateral needle approach to navicular bursocentesis, which avoids penetration of the deep digital flexor tendon (DDFT) and the need for radiographic control. Objective: To describe and evaluate the feasibility and efficacy of an ultrasound-guided, lateral bursocentesis technique. Methods: Cadaveric and in vivo experiments. Methods: The navicular bursa in 62 cadaveric forelimbs of 31 horses and in both forelimbs of 26 live horses, positioned with the foot flexed in a navicular block, were submitted to lateral, ultrasound-guided injection of 1.5 ml radiocontrast agent. Lateromedial radiographs were taken to locate the contrast. A second injection of 0.5 ml methylene blue was administered during needle withdrawal in cadaveric limbs to investigate the needle pathway during dissection. Results: Contrast agent was successfully deposited in the navicular bursa in 104 of 114 (91%) limbs and in the navicular bursa alone in 89 of 114 (78%) limbs. Dissection showed no evidence of penetration of the DDFT in cadaver limbs. Failure to inject the navicular bursa was significantly associated with poor quality of the ultrasound image (P = 0.04) and resulted in aberrant injection of the distal interphalangeal joint in five of 114 (4%) limbs, the peribursal soft tissues in four of 114 (4%) limbs and the digital flexor tendon sheath in one of 114 (0.9%) limbs. Synovial fluid was observed at the needle hub in 58% of live horses. Conclusions: It is unknown whether injection results obtained in the limbs of horses without disease can be extrapolated to horses with clinical disease of the podotrochlear apparatus. The localisation of contrast medium on radiographs may not accurately reflect the behaviour of local anaesthetic solution or therapeutic medications injected in the navicular bursa. Conclusions: This lateral, ultrasound-guided technique for injecting the navicular bursa is effective, does not penetrate the DDFT and avoids exposure of personnel to radiation.
© 2017 EVJ Ltd.
Publication Date: 2017-02-28 PubMed ID: 28128875DOI: 10.1111/evj.12673Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The research article discusses a new approach for injecting the navicular bursa in horses using ultrasound guidance, emphasizing the effectiveness of this method in both preserving the deep digital flexor tendon and avoiding radiographic exposure.
Objective and Methodology
- The primary objective of this study is to evaluate the effectiveness and feasibility of a new ultrasound-guided approach to navicular bursocentesis in horses—a procedure often needed for navicular disease—majorly focusing on avoiding deep digital flexor tendon (DDFT) penetration.
- Experimentation was carried out both on cadaveric equine forelimbs and live horses. They used a lateral, ultrasound-guided method to inject the navicular bursa, with a radiographic contrasting agent in use to assess the deposition and location of the agent.
- The study also tracked the needle pathway during dissection by injecting methylene blue in cadaveric limbs.
Results
- Successful deposition of the contrast agent in the navicular bursa was achieved in 91% of the injected limbs. The contrast agent was found to be exclusively in the navicular bursa in 78% of these cases.
- The dissection exposed no signs of DDFT penetration.
- Failure to deploy the injection in the navicular bursa was signicantly correlated with poor ultrasound image quality and resulted in miscued injections in the distal joints, soft tissues, and the digital flexor tendon sheath.
- In 58% of live horses, synovial fluid became visible at the needle hub.
Conclusions
- The research cautioned that the findings in this study—conducted in healthy horses—might not be directly applicable to horses suffering from clinical diseases of the podotrochlear apparatus.
- The research also mentioned that the behavior of anaesthetic solutions or therapeutic medications in the navicular bursa might not match the observed localisation of the contrast medium on the radiographs.
- Neveretheless, the successful outcomes of the study support that this lateral, ultrasound-guided technique for navicular bursa injection is effective, DDFT-sparing, and a choice to avoid radiation exposure to handling personnel.
Cite This Article
APA
Nottrott K, De Guio C, Khairoun A, Schramme M.
(2017).
An ultrasound-guided, tendon-sparing, lateral approach to injection of the navicular bursa.
Equine Vet J, 49(5), 655-661.
https://doi.org/10.1111/evj.12673 Publication
Researcher Affiliations
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France.
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France.
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France.
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France.
MeSH Terms
- Animals
- Bursa, Synovial / diagnostic imaging
- Cadaver
- Forelimb
- Horse Diseases / diagnostic imaging
- Horses
- Injections / methods
- Injections / veterinary
- Tarsal Bones
- Tendons / anatomy & histology
Citations
This article has been cited 2 times.- Cota LO, Malacarne BD, Dias LA, Neto ACP, Kneipp MLA, Cavalcante MA, Cunha MSLD, Paz CFR, Carvalho AM, Faleiros RR, Xavier ABDS. Mechanical nociceptive assessment of the equine hoof after navicular bursa anesthetic infiltration validated by bursography.. PLoS One 2022;17(6):e0269532.
- Evrard L, Joostens Z, Vandersmissen M, Audigié F, Busoni V. Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain.. Front Vet Sci 2021;8:675180.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
