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Home / Equine Research Bank / Vet Radiol Ultrasound / Ultrasound-guided arthrocentesis of the temporomandibular jo...
Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association2020; 61(3); 346-352; doi: 10.1111/vru.12836

Ultrasound-guided arthrocentesis of the temporomandibular joint in healthy adult horses is equivalent to blind arthrocentesis.

Abstract: Equine temporomandibular joint (TMJ) diseases are increasingly recognized as a problem for the well-being and performance of horses. Diagnosis is confounded by overlap of clinical signs associated with pathology of the oral cavity, poll, and cervical vertebrae. Arthrocentesis for intra-articular analgesia, sampling of synovial fluid, and medication is needed for diagnostic and therapeutic purposes. Ultrasound features of the normal TMJ and a blind arthrocentesis technique have been described, but a systematic approach to ultrasound-guided (USG) arthrocentesis has not been reported. Ultrasound guidance allows visualization of the TMJ that may prove beneficial in cases when pathology, abnormal anatomy, or clinician inexperience make blind arthrocentesis difficult. We hypothesized that USG arthrocentesis would result in fewer needle repositions than blind arthrocentesis. We also aimed to assess synovial fluid parameters for normal equine TMJs. A prospective randomized method comparison with crossover experimental design compared the number of needle positionings required for accurate injection of the TMJ using each technique. Arthrocentesis technique and operator experience were tested using cadavers and two operators. Injection success was confirmed using CT. The radiologist then applied both techniques in normal live horses. No statistically significant difference was noted between arthrocentesis techniques or operators (P > .05). No complications were observed in live horses following either technique. Synovial fluid parameters were largely within the normal range expected for other synovial joints. Either blind or USG arthrocentesis of the equine TMJ can be performed with minimal prior operator experience. Ultrasound-guided arthrocentesis is an alternative method and can be considered in cases with altered anatomy.
© 2020 American College of Veterinary Radiology.
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Publication Date: 2020-01-02 PubMed ID: 31896164DOI: 10.1111/vru.12836Google Scholar: Lookup
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  • 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.

This research investigated the efficacy of ultrasound-guided and blind arthrocentesis in diagnosing and treating temporomandibular joint (TMJ) diseases in horses. The study found no significant difference between the two techniques, suggesting both methods can be effectively used to perform arthrocentesis with minimal prior experience.

Study Purpose and Hypothesis

  • This study was conducted to evaluate and compare the effectiveness of ultrasound-guided (USG) arthrocentesis and blind arthrocentesis for the treatment and diagnosis of temporomandibular joint (TMJ) diseases in horses.
  • Although blind arthrocentesis techniques have been described previously, there was not yet a systematic approach to USG arthrocentesis for equine TMJ, making the research particularly important.
  • The hypothesis was that USG arthrocentesis would require a fewer number of needle repositions than blind arthrocentesis, potentially making it a more efficient and lower-risk procedure.

Study Methodology

  • The study employed a prospective randomized method comparison with a crossover experimental design. This means that each technique was tested multiple times and compared directly, with the order of techniques randomized.
  • To determine the efficacy of the techniques, the number of needle repositionings necessary for an accurate injection of the TMJ was measured and compared. This provided a quantitative measure of each technique’s efficiency.
  • The techniques were practiced on cadavers before being applied by the operators on live horses, increasing the safety and reliability of the procedures.
  • The success of each injection was then confirmed using computed tomography (CT).

Results and Implications

  • The study found no statistically significant difference between the two arthrocentesis techniques or the operators, indicating that both techniques can be utilized effectively to treat TMJ diseases in horses.
  • There were no reported complications in the live horses following either procedure, suggesting both are safe methods for use in live horses.
  • The synovial fluid parameters were largely within the normal expected range for other synovial joints, supporting robustness of the study.
  • Despite the fact that there was no significant difference found, the research does suggest that ultrasound-guided arthrocentesis is a viable alternative. This may be particularly useful in cases where altered anatomy makes blind arthrocentesis more challenging.

Cite This Article

APA
Norvall A, Cota JG, Pusterla N, Cissell D. (2020). Ultrasound-guided arthrocentesis of the temporomandibular joint in healthy adult horses is equivalent to blind arthrocentesis. Vet Radiol Ultrasound, 61(3), 346-352. https://doi.org/10.1111/vru.12836

Publication

Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
ISSN: 1740-8261
NlmUniqueID: 9209635
Country: England
Language: English
Volume: 61
Issue: 3
Pages: 346-352

Researcher Affiliations

Norvall, Amy
  • School of Veterinary Medicine, University of California, Davis, Davis, California.
Cota, Jose Guerrero
  • School of Veterinary Medicine, University of California, Davis, Davis, California.
Pusterla, Nicola
  • School of Veterinary Medicine, University of California, Davis, Davis, California.
Cissell, Derek
  • School of Veterinary Medicine, University of California, Davis, Davis, California.

MeSH Terms

  • Animals
  • Arthrocentesis / methods
  • Arthrocentesis / veterinary
  • Cadaver
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / pathology
  • Horses
  • Prospective Studies
  • Synovial Fluid
  • Temporomandibular Joint / diagnostic imaging
  • Temporomandibular Joint / pathology
  • Temporomandibular Joint Disorders / diagnostic imaging
  • Temporomandibular Joint Disorders / therapy
  • Temporomandibular Joint Disorders / veterinary
  • Ultrasonography, Interventional / veterinary

Grant Funding

  • UC Davis Center for Equine Health

References

This article includes 21 references
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Citations

This article has been cited 1 times.
  1. Pimentel KL, Carmalt JL. The Frequency of Communication Between the Synovial Compartments of the Equine Temporomandibular Joint: A Contrast-Enhanced Computed Tomographic Assessment.. Front Vet Sci 2021;8:753983.
    doi: 10.3389/fvets.2021.753983pubmed: 34760960google scholar: lookup
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