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Abstract

OBJECTIVE

To identify radiographic locations of soft tissue attachments in the tarsal region of horses and describe any variability in the gross anatomy of those attachments.

SAMPLE

15 cadaveric limbs from 8 adult horses.

PROCEDURES

8 limbs were used for dissection and radiography of soft tissue structures, with metallic markers used to identify radiographic locations of soft tissue attachments. The remaining 7 limbs were used to evaluate anatomic variations in the insertion of the tendon of the fibularis tertius muscle. A consensus list of preferred radiographic views for evaluating each soft tissue attachment was created.

RESULTS

The dorsoplantar, dorsoproximolateral-plantarodistomedial oblique (35° proximal and 45° lateral), dorsoproximomedial-plantarodistolateral oblique (10° proximal and 15° medial), and plantaroproximal-plantarodistal oblique (70° proximal; flexed) views were preferred for evaluating the collateral ligaments. The standard oblique views and plantaroproximal-plantarodistal oblique (70° proximal; flexed) view were preferred for evaluating the tendinous attachments of the gastrocnemius and superficial digital flexor muscles. All 4 standard views were necessary for evaluating the tendinous attachments of the cranial tibial and fibularis tertius muscles, the dorsal tarsal ligament, and the origin of the suspensory ligament. Three configurations of the insertion of the fibularis tertius tendon were identified grossly. In limbs with osteoarthritis of the distal tarsal joints, the dorsal tarsal ligament firmly adhered to the centrodistal tarsal joint.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that attachments of soft tissue structures in the tarsal region of horses were in distinct radiographically identifiable locations and that visualization of individual soft tissue attachments could be optimized with certain radiographic views, including some nonstandard views.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To determine if equine cadavers modified with joint distension would yield higher fluid volumes, require fewer needle redirects, and improve student self-efficacy.

SAMPLE

19 third-year veterinary students.

METHODS

Voluntary participation was sought during 4 sessions of an equine arthrocentesis and diagnostic analgesia laboratory. Half of the sessions were provided with unmodified cadavers and half were provided with cadavers modified with joint distention. Prior to and after the laboratory, participating students completed surveys regarding their self-efficacy with arthrocentesis of the metacarpophalangeal and distal interphalangeal joints. During the study, the number of needle redirects and the volume of fluid obtained was recorded.

RESULTS

Increased fluid volumes were obtained from the modified metacarpophalangeal and distal interphalangeal joints. No difference was identified in number of needle redirects between cadaver types for either joint. Self-efficacy scores increased at the end of the laboratory for arthrocentesis of the metacarpophalangeal joint in both modified and unmodified groups. Self-efficacy scores increased at the end of the laboratory for arthrocentesis of the distal interphalangeal joint for the modified but not unmodified groups.

CLINICAL RELEVANCE

Modified equine cadavers provided a higher fluid yield following arthrocentesis compared to unmodified cadavers, but despite this, multiple attempts were required for proper needle placement. Performing equine arthrocentesis improved student self-efficacy with the task. Given our results, the model used for introduction to performing equine arthrocentesis may be less important than practice with the skill. In order to improve proficiency and self-efficacy, equine arthrocentesis should be provided multiple times throughout the veterinary curriculum.

Free access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVES

Diagnosis of equine septic arthritis is not straightforward, and increasing time between onset, diagnosis, and treatment can have serious consequences for quality of life. Defensins are used in diagnosis of human joint infection. The presence of beta defensins (BDs) in equine synovial fluid and their utility as a biomarker of sepsis has not been investigated; therefore, our objectives were to (1) compare in vitro gene expression of lipopolysaccharide (LPS)-stimulated equine neutrophils to unstimulated neutrophils and (2) compare BD protein expression from normal, aseptically inflamed, and septic equine joints.

ANIMALS

5 horses for isolated neutrophil BD expression and 21 synovial fluid samples from 14 horses.

PROCEDURES

RT-qPCR analysis was performed for BD gene expression of stimulated and unstimulated equine peripheral neutrophils. BD protein expression was evaluated from equine joints with no disease, aseptic inflammation, and septic inflammation using a commercial ELISA designed for horses and analyzed with a Kruskal-Wallis test (significant at P < .05).

RESULTS

A significant increase was noted in expression of BD-3 in LPS stimulated as compared to unstimulated neutrophils. There were no significant differences in BD expression noted between joints with no disease, aseptic inflammation, and septic inflammation. Low case numbers and different types of cases in the aseptic inflammation group were main limitations. BD expression patterns in samples from stimulated equine peripheral neutrophils and synovial fluid were identified.

CLINICAL RELEVANCE

BDs are detectable in equine synovial fluid and can be stimulated from peripheral neutrophils. Further examination is needed to define their role as biomarkers of joint disease.

Open access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To compare palpation and ultrasound scores of effusion of the medial femorotibial and femoropatellar joints of horses.

ANIMALS

40 horses (80 stifles) were evaluated over a 12-week period.

METHODS

Horses > 1 year of age without history of stifle disease were enrolled from September to December 2022. Palpation of right and left medial femorotibial and femoropatellar joint compartments was performed. Amount of effusion was scored by a board-certified large animal surgeon, a third-year large animal surgery resident, and an equine sports medicine intern. Effusion of right and left medial femorotibial and femoropatellar joints was quantified with ultrasound by a board-certified equine sports medicine and rehabilitation clinician. Amount of effusion on palpation and ultrasound was graded as none-mild (1), moderate (2), or severe (3). A 2-way intraclass correlation coefficient evaluated interrater reliability of palpation scores. The Spearman rank correlation determined association between palpation and ultrasound scores.

RESULTS

Interrater reliability for palpation of effusion was poor between all observers for all joint compartments. No significant correlation was identified between palpation and ultrasound scores for any joint compartment for any observer.

CLINICAL RELEVANCE

Clinicians often rely on palpation of joint effusion as an indication of stifle pathology. We found interrater reliability to be poor for palpation scores, indicating low agreement for palpation of joint effusion between clinicians within our group. No correlation was found between palpation and ultrasound scores for joint effusion, indicating that clinicians should not rely on palpation alone to quantify joint effusion of the medial femorotibial and femoropatellar joints.

Free access
in Journal of the American Veterinary Medical Association