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Lateral radiographic image of a left tarsus with pertinent structures identified to facilitate CD joint injection. Blue oval, dorsomedial pouch of the tibiotarsal joint; Red circle, cunean bursa; Yellow circle, point of CD joint injection
Source publication
Background
Injection of the centrodistal (CD) joint in the horse is a commonly performed procedure for both diagnostic and therapeutic purposes. This procedure can be technically challenging, and while radiographic guidance has been previously used, ultrasound localised injection of the CD joint has not been described.
Objectives
The purpose of th...
Citations
... Due to the advantages of ultrasound, such as portability, lack of radiation, low cost, and high accuracy, its application in joint cavity injection has become increasingly common 2 . Similar animal studies confirmed that ultrasound guidance improved the accuracy of knee and temporomandibular joint injections in animal models, such as rabbits and rats [3][4][5][6] . Therefore, the present study used ultrasoundguided injection to improve the modeling method based on this model. ...
A simple and feasible rabbit model of carpal tunnel syndrome (CTS) was established using an animal experimental study. Twenty-four New Zealand white rabbits were randomized into a normal group (Group C), a glucose injection model group (Groups N-M) and an ultrasound-guided injection model group (Groups U-M). Each group consisted of 8 rabbits.Electrophysiological and ultrasound examinations were performed before sampling. Hematoxylin-eosin (H&E) staining and electron microscopy were performed to observe the neuropathological changes. During electrophysiological testing 1 week after modeling, the amplitudes of the sensory nerve conduction velocity (SNCV), distal motor latency (DML) and compound muscle action potential (CMAP ) in the U-M group were significantly different compared to the C group and the N-M group (P < 0.05). Five weeks after modeling, the amplitudes of the SNCV, DML and CMAP in the U-M group and the C group were significantly different (P < 0.05). These differences were statistically significant compared to the DML and CMAP in the N-M group (P < 0.05), and the changes in these parameters were more significant than the results 1 week after modeling (P < 0.05). The difference in CMAP amplitude between the N-M group and C group was statistically significant (P < 0.05), but the other parameters were not significantly different (P > 0.05). Compared to the original modeling method, four injections of 0.3 ml of 10% glucose solution under ultrasound guidance reduced the time required to establish the disease model and increased the stability of the model. Therefore, this technique is a simple and feasible method for establishing a model of rabbit carpal tunnel syndrome.
Background
Tibial perineural analgesia has often been reported to fail to achieve nerve desensitisation in horses. Ultrasound‐guided (US‐guided) techniques have recently been described to improve tibial perineural desensitisation.
Objectives
To compare US‐guided and ‘blind’ tibial perineural analgesia techniques in lameness investigation.
Study design
Randomised clinical trial.
Methods
Horses presenting for lameness investigation, which required tibial perineural analgesia, were randomly assigned either to a US‐guided or blind injection group. The efficacy of perineural analgesia was assessed by testing the loss of skin sensation at the medial and lateral heel bulbs. Skin sensation was assessed, prior to injection and then at four intervals post‐injection (10–15, 20–25, 30–35 and 40–45 min) using a hand‐held digital algometer with a 1 mm diameter pin; a value of 25 N was defined as indicative of skin desensitisation. The time taken to perform each injection technique and any adverse reactions were recorded. Summary statistics were performed to examine differences between groups. The frequency of skin desensitisation was compared between groups using a Fisher's exact test and the length of time taken to perform injections was compared using a Mann–Whitney U test.
Results
Sixteen US‐guided and 11 blind injections were included in the study. All cases undergoing US‐guided injection lost skin sensation, whereas this occurred in only one case receiving the blind injection. The US‐guided group had a significantly higher probability of skin sensation loss ( p < 0.001), although the injection technique took significantly longer to complete compared to the blind group ( p < 0.001). No adverse reactions were noted with either perineural injection technique.
Main limitations
Limited number of cases for each injection group.
Conclusions
These findings suggest that US‐guided tibial perineural injection is more likely to result in adequate and prompt tibial perineural analgesia compared to the blind injection technique, although it takes longer to complete.
