Fragmented acupuncture needle as a linear metallic foreign body near the proximal interphalangeal joint of a horse.
Abstract: To describe the clinical presentation, diagnosis, and treatment of a fragmented, migrating acupuncture needle near the palmar proximal interphalangeal joint (PIPJ) of a horse. Methods: A 9-year-old Warmblood cross mare. Unassigned: The mare presented for evaluation of a linear metallic foreign body on the palmar lateral aspect of the PIPJ following acupuncture treatment. The mare had a pinpoint puncture wound and sensitivity to palpation over the lateral aspect of the PIPJ region. The referring veterinarian performed radiographs and found a linear metallic foreign body near the lateral palmar PIPJ. Ultrasonographic examination demonstrated a hyperechoic lesion consistent with a metallic object in the soft tissues of the palmar lateral aspect of the PIPJ. Results: The horse was anesthetized, and the linear metallic foreign body was removed. The use of intraoperative ultrasound and digital radiographs assisted in determining the location of and surgical approach to remove the foreign body. The linear metallic foreign body was the fragmented segment (body) of an acupuncture needle. The mare recovered from surgery uneventfully and returned to the previous level of activity. Conclusions: This report demonstrates the potential risks of prolonged retention and or delayed removal of acupuncture needles in the form of needle fragmentation and migration. It also demonstrates the use of imaging in determining the location and position of small, thin metallic foreign bodies to aid in surgical approach and removal.
Publication Date: 2024-05-08 PubMed ID: 38718821DOI: 10.2460/javma.24.03.0205Google Scholar: Lookup
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Summary
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Overview
- A horse presented with a fragmented acupuncture needle lodged near its proximal interphalangeal joint (PIPJ).
- The study details the clinical signs, diagnostic process, surgical removal, and recovery outcome.
Clinical Presentation
- The patient was a 9-year-old Warmblood cross mare.
- The mare had undergone acupuncture treatment prior to presentation.
- Clinical signs included a pinpoint puncture wound and sensitivity to palpation over the lateral aspect of the palmar PIPJ region.
Diagnostic Methods
- Radiographs taken by the referring veterinarian identified a linear metallic foreign body near the lateral palmar aspect of the PIPJ.
- Ultrasonography showed a hyperechoic lesion in the soft tissues of the same area, consistent with a metallic object.
- These imaging techniques helped confirm the presence, size, and exact location of the foreign body for treatment planning.
Treatment and Surgical Approach
- The horse was anesthetized for surgery.
- Intraoperative ultrasonography and digital radiographs were used during surgery to accurately locate the foreign body.
- The linear metallic object was carefully removed—it was identified as a fragmented segment of an acupuncture needle.
Outcomes and Follow-up
- The mare recovered from surgery without complications.
- Postoperative recovery was uneventful, and the horse returned to its previous activity level.
Significance and Implications
- The case highlights potential risks associated with acupuncture needles, particularly fragmentation and migration if retained for prolonged periods.
- It emphasizes the importance of promptly removing retained acupuncture needles to avoid complications.
- The study demonstrates the utility of advanced imaging (ultrasound and radiographs) to localize small, thin metallic foreign bodies accurately, aiding surgical planning and removal.
- Overall, it provides valuable insight into managing similar foreign body cases in equine patients and improving clinical outcomes.
Cite This Article
APA
Trostle SS, Kearney EM, Medoff M, Devaney S.
(2024).
Fragmented acupuncture needle as a linear metallic foreign body near the proximal interphalangeal joint of a horse.
J Am Vet Med Assoc, 262(8), 1-4.
https://doi.org/10.2460/javma.24.03.0205 Publication
Researcher Affiliations
- 1Blue Ridge Equine Clinic, Earlysville, VA.
- 1Blue Ridge Equine Clinic, Earlysville, VA.
- 1Blue Ridge Equine Clinic, Earlysville, VA.
- 2Virginia Equine Clinic PLLC, Manakin-Sabot, VA.
MeSH Terms
- Animals
- Horses
- Female
- Foreign Bodies / veterinary
- Foreign Bodies / therapy
- Foreign Bodies / surgery
- Acupuncture Therapy / veterinary
- Acupuncture Therapy / adverse effects
- Acupuncture Therapy / instrumentation
- Needles / veterinary
- Horse Diseases / therapy
- Horse Diseases / diagnosis
- Forelimb
Citations
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