Arthrocentesis

Question 1

What are two primary reasons for performing an arthrocentesis?

Answer 1

Diagnostics

Therapeutics

Question 2

What are two therapeutic treatments you can perform with an arthrocentesis?

Answer 2

Medications

Lavage

Question 3

What are 4 routinely treated synovial structures of the forelimb?

Answer 3

Distal Interphalangeal (coffin)
Metacarpophalangeal joint (fetlock)
Digital flexor tendon sheath
Carpal joints

Question 4

What are 4 routinely treated synovial structures of the hindlimb?

Answer 4

Metatarsophalangeal joint (fetlock)
Digital flexor tendon sheath
Tarsometatarsal/Distal intertarsal
Stifle

Question 5

What gauge and length needle do you use to perform an arthroentesis?

Answer 5

20G 1” needle

Question 6

What type of restraint is recommended for an arthrocentesis?

Answer 6

Physical restraint is always recommended over chemical.

NOTE: NEVER have the owner restrain for you.

Question 7

If you are treating or flushing a joint via arthrocentesis, what is the best kind of restraint?

Answer 7

Chemical restraint (sedation).

NOTE: Sedation decreases awareness AND provides some analgesia, tranquilization is just an anxiolytic.

Question 8

If using Acepromazine as a tranquilizer, how might it affect your exam?

Answer 8

For some horses, lameness becomes less apparent.

Question 9

If after you place your needle, there is no fluid but you’re pretty confident of placement, what can you do before trying a restick?

Answer 9

“Spin” the needle.

Question 10

When preparing for an arthrocentesis, do you need to clip the hair?

Answer 10

It doesn’t actually matter, but clipping will allow you to see the site a bit better.

Question 11

What are 2 methods that increase the joint contamination risk?

Answer 11

Large gauge needle (greater than 20G)

Spinal needles

Question 12

For our lab, what will we be placing in each joint because we’re not great at aseptic yet?

Answer 12

Naxcel (Ceftiofur)

NOTE: Can go SQ, IM and IV.

Question 13

In practice, what can you give to reduce the risk of joint infection, especially after infusing something like Adequan?

Answer 13

125mg Amikacin

Question 14

For a radiocarpal joint arthrocentesis, what are your landmarks?

Answer 14

Palpate the distal medial ridge of the radius and the proximal edge of the radiocarpal bone. Needle will go between these two, and medially.

Question 15

What are the landmarks for a midcarpal joint arthrocentesis?

Answer 15

Distal ridge of the radiocarpal bone and the proximal edge of the 3rd carpal bone.

Question 16

After you remove your needle during arthrocentesis, how long should you maintain digital pressure?

Answer 16

Approx. 1 minute.

Question 17

What is your landmark for a tibiotarsal joint arthrocentesis?

Answer 17

Medial or lateral to the saphenous vein as it crosses the tarsus.

Question 18

What is the landmark for a tarsometatarsal joint arthrocentesis?

Answer 18

Just proximal to the head of the 4th metatarsal.

Question 19

Should we give anything post-op with an arthrocentesis>?

Answer 19

Phenylbutazone (2.2mg/kg)