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Home / Equine Research Bank / Equine Vet J / Assessment of intrasynovial injection in horses by contrast-...
Equine veterinary journal2020; 53(6); 1159-1168; doi: 10.1111/evj.13388

Assessment of intrasynovial injection in horses by contrast-enhanced ultrasonography using air bubbles created by agitation of solution.

Abstract: Accuracy of intrasynovial injections can be challenging to assess in a clinical setting in horses. Contrast-enhanced ultrasonography (CEUS) using injectate agitated with air has been used to determine the success rates of synovial injections in human rheumatology. Objective: To assess the diagnostic sensitivity and specificity of CEUS and to describe its clinical use. Methods: Cadaveric study followed by a prospective descriptive observational study. Methods: Part 1: CEUS was performed following injection of agitated methylene-blue solution targeting 13 different anatomical synovial structures from three equine cadavers. Contrast was seen as hyperechoic dots, patches or lines on ultrasonography. CEUS was classified as positive if contrast was considered to be intrasynovial and negative if contrast was considered to be extrasynovial. A second synoviocentesis was performed to determine if the injection was intrasynovial based on the presence or absence of methylene-blue. Estimates of sensitivity and specificity were calculated. Part 2: CEUS was performed following injection of agitated solutions targeting synovial structures as part of routine investigation and treatment of clinical cases. Results: Part 1: CEUS was correctly classified as positive or negative in all intrasynovial and extrasynovial injections respectively. The sensitivity estimate was 100% (CI 93%-100%) and the specificity estimates was 100% (CI 16%-100%). Part 2: The technique was used safely for 26 injections (14 horses; 19 different synovial structures) administered to localise or treat lameness. Traumatic intersynovial communications or synovial membrane defects were identified using CEUS in 3 horses. Conclusions: The low number of extrasynovial injections in Part 1 resulted in an imprecise specificity estimate. Conclusions: In horses, CEUS performed following intended intrasynovial injection can be useful for identifying unsuccessful injections.
© 2020 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2020-12-21 PubMed ID: 33222248DOI: 10.1111/evj.13388Google Scholar: Lookup
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  • Journal Article
  • Observational Study
  • Veterinary

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 investigates the efficiency and reliability of contrast-enhanced ultrasonography (CEUS) in assessing the accuracy of intrasynovial injections in horses, using an agitated solution with air. The study reveals that CEUS offers 100% sensitivity and specificity and can identify unsuccessful injections.

Objective and Methodology

  • The primary objective of the research was to determine the diagnostic sensitivity and specificity of CEUS in the clinical setting, particularly in relation to synovial injections in horses.
  • The methodology involved two parts. In the first part, a cadaver study was performed using CEUS after injecting an agitated methylene-blue solution to virtual mapping of different anatomical synovial structures from three equine cadavers. The result classifications were defined as positive for intrasynovial contrast and negative for extra-synovial contrast. A second synoviocentesis was performed to validate the results of the injection based on the presence or absence of methylene-blue.

Results

  • In the first part of the study, CEUS was able to correctly classify all intrasynovial and extrasynovial injections. The research reported a sensitivity estimate of 100% (CI 93%-100%) and a specificity estimate of 100% (CI 16%-100%).
  • In the second part, CEUS was safely applied for 26 injections (across 14 horses and 19 different synovial structures) to determine the precise locations or to treat lameness. CEUS was also successful in identifying traumatic intersynovial communications or synovial membrane defects in 3 horses.

Conclusions

  • The study reports a low number of extrasynovial injections in the first part, thus leading to an imprecise specificity estimate.
  • However, the study concludes that CEUS can indeed be a valuable tool for identifying unsuccessful intrasynovial injections in horses.

Cite This Article

APA
Ogden NKE, Cullen MD, Stack JD. (2020). Assessment of intrasynovial injection in horses by contrast-enhanced ultrasonography using air bubbles created by agitation of solution. Equine Vet J, 53(6), 1159-1168. https://doi.org/10.1111/evj.13388

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 6
Pages: 1159-1168

Researcher Affiliations

Ogden, Nadine K E
  • Faculty of Veterinary Science, Leahurst Equine Hospital, University of Liverpool, Neston, UK.
Cullen, Matthew D
  • Faculty of Veterinary Science, Leahurst Equine Hospital, University of Liverpool, Neston, UK.
Stack, John D
  • Faculty of Veterinary Science, Leahurst Equine Hospital, University of Liverpool, Neston, UK.

MeSH Terms

  • Animals
  • Horses
  • Injections, Intra-Articular / veterinary
  • Prospective Studies
  • Sensitivity and Specificity
  • Synovial Membrane / diagnostic imaging
  • Ultrasonography / veterinary

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Citations

This article has been cited 1 times.
  1. 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.
    doi: 10.1111/evj.14133pubmed: 38989893google scholar: lookup
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