title: Comparison between palpation and ultrasonography for evaluation of experimentally induced effusion in the distal interphalangeal joint of horses.
abstract: OBJECTIVE
  To ultrasonographically quantify experimentally induced effusion of the distal interphalangeal (DIP) joint of horses and compare results with those obtained with palpation.
  
  
  METHODS
  8 forelimbs from equine cadavers and forelimbs of 5 mares.
  
  
  METHODS
  Preliminary ex vivo experiments were performed to validate the methods. Then, the DIP joints of the forelimbs of standing horses were serially distended with saline (0.9% NaCl) solution (1, 4, and 10 mL) by injection through an intra-articular catheter. Two ultrasonographers measured distension of the dorsal recess of the DIP joint, and 2 surgeons, who were not aware of the volume injected, graded joint effusion by palpation.
  
  
  RESULTS
  Intraobserver and interobserver repeatability was excellent for ultrasonographic measurements. Interobserver agreement for use of palpation to detect joint distension was moderate (κ = 0.45). There was an overall increase in the palpation distension grade with an increase in injected volume. Sensitivity for detection with palpation of larger volumes (4 and 10 mL) was high (92% and 100%, respectively). However, sensitivity was lower (57%) for detection with palpation of minimal distension (1 mL).
  
  
  CONCLUSIONS
  Although palpation provided a reliable clinical assessment of DIP joint effusion for volumes of 4 to 10 mL, ultrasonographic measurements were easy to obtain, more accurate, and able to detect smaller amounts of distension. This may be clinically relevant for the assessment of effusion of the DIP joint that can arise in horses with early osteoarthritis or infectious arthritis with concomitant soft tissue swelling that precludes accurate assessment with palpation.
authors.affiliation: Comparative Orthopaedic Research Laboratory, Département de sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 7C6, Canada.
authors.forename: Julien
authors.initials: J
authors.lastname: Olive
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lambert
authors.forename: Kirstin A
authors.initials: KA
authors.lastname: Bubeck
authors.forename: Guy
authors.initials: G
authors.lastname: Beauchamp
authors.forename: Sheila
authors.initials: S
authors.lastname: Laverty
mesh_terms: D000818:Animals; D002102:Cadaver; D005260:Female; D005552:Forelimb / Q000000981:diagnostic imaging; D006734:Horse Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D006736:Horses; D007592:Joint Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000662:veterinary*; D007596:Joints / Q000000981:diagnostic imaging; D010003:Osteoarthritis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000662:veterinary*; D010173:Palpation / Q000379:methods* / Q000662:veterinary; D014033:Toe Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods* / Q000662:veterinary