Ultrasound-guided coxofemoral arthrocentesis in horses.
Authors: David F, Rougier M, Alexander K, Morisset S
Journal: Equine veterinary journal
Summary
# Editorial Summary: Ultrasound-guided Coxofemoral Arthrocentesis in Horses Hip joint pain in horses is frequently overlooked because of diagnostic challenges; the coxofemoral joint's depth and anatomical proximity to the sciatic nerve make landmark-based arthrocentesis unreliable and potentially hazardous in adult horses. David and colleagues evaluated an ultrasound-guided technique for accessing the hip joint in nine standing horses, injecting contrast medium under real-time visualisation and confirming needle placement radiographically whilst monitoring animals for post-procedure complications over 10 days. All 18 joints were successfully injected intra-articularly with minimal needle repositioning (mean 1.5 attempts), synovial fluid was retrieved in 7 of 18 joints, periarticular leakage occurred in only 2 joints, and no adverse effects developed during the monitoring period—the entire procedure required approximately 4 minutes per joint. This technique represents a significant advance for equine practitioners seeking to diagnose or treat hip pathology, enabling accurate intra-articular access without general anaesthesia and substantially reducing the risk of iatrogenic nerve damage or periarticular medication placement. Although the authors acknowledge that clinical validation remains necessary, ultrasound-guided hip arthrocentesis offers a practical tool for investigating suspected coxofemoral joint disease and administering therapeutic agents where conventional approaches would be prohibitively risky.
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Practical Takeaways
- •Ultrasound-guided technique offers a safer, more reliable alternative to landmark-based coxofemoral arthrocentesis by avoiding sciatic nerve proximity and improving accuracy
- •The procedure is well-tolerated in standing horses requiring only minimal sedation, making it practical for field use in diagnostic and therapeutic applications
- •Real-time ultrasonic visualization enables confirmation of intra-articular needle placement and allows diagnosis of hip joint pain, infection, and safe medication administration
Key Findings
- •Ultrasound-guided coxofemoral arthrocentesis was successful in all 18 joints (100% accuracy) in 9 standing horses with minimal restraint required
- •Mean needle repositionings required was 1.5 ± 1.3 per joint, with synovial fluid obtained in 7/18 joints
- •Procedure took mean 4.3 ± 2.1 minutes for joint localization, needle positioning and injection with no complications observed over 10-day follow-up period
- •Minimal periarticular leakage occurred in only 2/18 joints, demonstrating reliable intra-articular placement