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Frontiers in veterinary science2024; 11; 1368131; doi: 10.3389/fvets.2024.1368131

Contrast arthrography of the equine temporomandibular joint.

Abstract: Disorders of the equine temporomandibular joint (TMJ) cause clinical problems and detailed investigations of this joint are becoming more common. Specialist radiographic projections have the potential to highlight osseous abnormalities; however, the ability to assess the intra-articular soft tissue structures is currently limited to computed tomography (with, or without contrast enhancement) or magnetic resonance imaging. Both modalities are expensive and not readily accessible. Unassigned: To develop a technique of contrast arthrography of both compartments of the equine TMJ in cadavers and then perform the refined technique in three living horses as a proof-of-principle. Unassigned: A descriptive, experimental, study. Unassigned: Contrast arthrography of the discomandibular and discotemporal joint compartments of both TMJs was performed in 12 cadaveric equine heads using needles placed in the caudal pouches of the respective joint compartments. Radiographs were taken using previously published techniques, repeated with the mouth open and after air had been injected into the joints, to perform a double-contrast study. The TMJs of three healthy horses were subsequently examined to determine the validity of the procedure in live animals. Unassigned: Single and double-contrast arthrography allowed delineation of the dorsal and ventral surfaces of the intra-articular disc in addition to filling the rostral and caudal joint pouches of the independent joint compartments. Contrast extravasation was common, and in two instances iatrogenic disc penetration resulted in the false diagnosis of pathologic disc perforation. The techniques were well tolerated in all three live horses. Unassigned: Low number of horses. Unassigned: Contrast arthrography allows interpretation of intra-articular soft tissue structures, but caution is advised in diagnosing intra-articular disc perforation. Even with experience, accessing the discomandibular joint can be challenging.
Publication Date: 2024-03-18 PubMed ID: 38562918PubMed Central: PMC10983794DOI: 10.3389/fvets.2024.1368131Google Scholar: Lookup
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  • Journal Article

Summary

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This research article discusses the development of a technique for contrast arthrography in horse temporomandibular joints (TMJ). This method aims to fill knowledge gaps in the understanding of soft tissue structures within these joints, presenting a more affordable and accessible approach compared to current modalities. The procedure has been tested on cadaveric equine heads and subsequently validated on three living horses.

Objective of the Study

The research aims to uncover and test a simple, cost-effective method of arthrography for both compartments of the TMJ in horses. Arthrography involves using a contrast agent (a special dye) to create detailed images of joints. This technique holds the potential to improve the diagnosis and treatment of TMJ disorders in horses by providing a deeper understanding of the soft tissue structures within the joint.

Methods

The researchers conducted contrast arthrography of two specific compartments of the TMJ – the discomandibular and discotemporal joint compartments – using 12 cadaveric equine heads. The procedure involved:

  • Placement of needles into the caudal pouches of the joint compartments
  • Imaging of the joints using a set of specific radiographic techniques with the horse’s mouth both open and closed
  • Injecting air into the joints to run a double-contrast study

Following this, the procedure was performed on three living horses to assess its feasibility and tolerance in live animals.

Findings

The research findings indicate that single and double-contrast arthrography can help to illustrate the dorsal and ventral surfaces of the intra-articular disc in addition to filling the rostral and caudal joint pouches of the independent joint compartments. However, the procedure has its limitations:

  • Contrast leakage or extravasation was a common occurrence.
  • In two cases, the procedure resulted in iatrogenic (caused by medical examination or treatment) disc perforation which led to a false diagnosis of pathologic disc perforation.

Nevertheless, the techniques were well accepted by all three live horses, demonstrating the procedure’s potential as a diagnostic tool.

Limitations and Conclusion

The study was conducted on a small number of horses, which might limit the applicability of its findings across a broader range of cases and scenarios. Despite demonstrating the capability of contrast arthrography in interpreting intra-articular soft tissue structures, the researchers caution against its use for diagnosing intra-articular disc perforation. They further noted that accessing the discomandibular joint can be challenging even with experience.

Cite This Article

APA
Kim CS, Reisbig NA, Carmalt JL. (2024). Contrast arthrography of the equine temporomandibular joint. Front Vet Sci, 11, 1368131. https://doi.org/10.3389/fvets.2024.1368131

Publication

ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 11
Pages: 1368131
PII: 1368131

Researcher Affiliations

Kim, Clara S
  • Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, Saskatoon, SK, Canada.
Reisbig, Nathalie A
  • Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, Saskatoon, SK, Canada.
Carmalt, James L
  • Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, Saskatoon, SK, Canada.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Citations

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