title: Dorsolateral approach for arthrocentesis of the centrodistal joint in horses.
abstract: OBJECTIVE
  To develop a dorsolateral approach to the centrodistal (distal intertarsal) joint in horses and compare its success rate with that of the traditional medial approach in that joint.
  
  
  METHODS
  25 cadaveric equine hind limbs, ultrasonographic images, and radiographic views of the tarsal region of 5 and 59 healthy horses, respectively, and 22 horses with a clinical indication for centrodistal joint centesis.
  
  
  METHODS
  The dorsolateral approach was established anatomically (3 cadaveric limbs), ultrasonographically (5 horses), and radiographically (59 horses). Centrodistal joint arthrocentesis was performed in 22 cadaveric hind limbs and 22 horses; the number of needle repositionings required for procedure completion via the medial (in vitro) and the dorsolateral approach (in vitro and in vivo) was determined.
  
  
  RESULTS
  For the dorsolateral approach to the centrodistal joint, the injection site was 2 to 3 mm lateral to the long digital extensor tendon and 6 to 8 mm proximal to a line drawn perpendicular to the axis of the third metatarsal bone through the proximal end of the fourth metatarsal bone. The needle was directed plantaromedially (angle of approx 70 degrees from the sagittal plane). The number of needle repositionings required to complete centrodistal joint centesis via the dorsolateral and medial approaches was not significantly different.
  
  
  CONCLUSIONS
  In a clinical setting, the dorsolateral approach to the centrodistal joint in horses appears to have some advantages over the traditional medial approach. The success rate of arthrocentesis was similar via either approach, and palpation of the anatomic landmarks was easy.
authors.affiliation: Clinic of Orthopaedics in Large Animals, Department of Horses and Small Animals, Vienna University of Veterinary Medicine, A-1210 Vienna, Austria.
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: Just
authors.forename: Bianca
authors.initials: B
authors.lastname: Patan
authors.forename: Theresia F
authors.initials: TF
authors.lastname: Licka
mesh_terms: D000818:Animals; D001175:Arthrography / Q000379:methods / Q000662:veterinary; D005260:Female; D006614:Hindlimb / Q000000981:diagnostic imaging / Q000473:pathology; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006736:Horses; D008297:Male; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D019152:Paracentesis / Q000379:methods / Q000662:veterinary*; D013582:Synovial Fluid