Arthrocentesis Flashcards Preview

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Flashcards in Arthrocentesis Deck (22)
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1

Why would you do an arthrocentesis ?

Lameness evaluation

Clinopathological evaluation

Contrast studies

Wound involvement

Joint communications

Theraputic — medication or lavage

2

Routinely treated synovial structures of the forelimb?

Distal interphalangeal (DIP)
Metacarpal phalangeal (MCP)
DFTS
Carpal joints

3

Routinely treated synovial structures of the hindlimb?

Metatarsal phalangeal (MTP)
DFTS
TMT/DIT
Stifle

4

T/F: you should always clip for the area for IA injections

False

Site is sterile clipped or non clipped

Clipping can actually increase little hair debris

5

What needle size is used for most IA injections?

20g 1”

Larger gauge needles increases risk of contamination

6

How can you minimize joint contamination ?

Use needles ONCE
Limit use of spinal needles or remove hair prior to use of spinal needles

Removal of hair might be contraindicated with hypodermic needles

>18G needles increase risk of hair contamination

Allow fluid to drip out of hub or aspirate prior to injection to clear tissue and hair debris

IA antibiotics

7

500mg of __________ provides 72hrs concentration >MIC for most common pathogens

Amikacin

8

What IA antibiotic are we administering to our donkeys and how much?

Ceftiofur (50mg/ml)

Giving 2mls (100mg)

9

What are the landmarks for radiocarpal arthrocentesis ?

Palate distal medial ridge of the radius and proximal edge of the radiocarpal bone

Insert needle midway between these, and between the ECR and CDE tendons

10

What are the landmarks for an intercarpal arthrocentesis ?

Between distal ridge of radiocarpal bone and proximal edge of 3rd carpal bone

11

What synovial structures communicate at the carpus?

Inter-carpal joint and carpometacarpal joint (CMC)

12

What are the landmarks for tibiotarsal joint arthrocentesis ?

Palate medial malleolus of tibial

Insert needle medial or lateral to saphenous vein as it crosses the tarsus (1-1.5” distal to medial malleolus in horses)

13

Landmarks for the tarsometatarsal joint?

Insert needle just proximal to the head of the 4th metatarsal (lateral splint) dorsomedially and at a slightly distal angle

14

What needle size do you use for arthrocentesis of distal interphalangeal (coffin) joint?

20g 1 1/2”

15

What are sites for a distal interphalangeal joint arthrocentesis ?

Dorsal parallel just proximal to coronary band

Dorsal perpendicular

Lateral

16

What are the landmarks for a metacarpophalangeal joint arthrocentesis ?

Collateral seasmoidean ligament approach
- joint is flexed

OR
Proximal palmar/plantar pouch approach
Cranial border: Palate palmar MC3

Plantar border: Dorsal border of suspensory lig

Proximal border: Distal border of MC4 (splint bone)

Lateral border: Proximal lateral seasmoid bone

17

What needle size is used to do an arthrocentesis on the stifle?

20G 1.5” needle

18

What two approaches are used for the stifle?

FP— lateral approch
-lateral to patellar lig and 2” dorsal to lateral meniscus insert until you feel bone

MFT
—proximal to tibia between medial patellar ligament and medial femorotibial ligament

19

T/F: it is best to inject all compartments when treating the stifle

True

20

The femoropatellar joint communicates with what compartments?

MFT (medial femorotibial )
And LFT (lateral femorotibial)

21

What are the landmarks for the cranial approach to the femorotibial compartments? And what size needle do you use?

Between medial and lateral patellar ligaments
Directed proximally into the trochlear groove

3” spinal needle

22

What landmarks do you use for a lateral approach to the femorotibial joint spaces and what needle do you use?

Caudal to the lateral patellar ligament and 6cm proximal to the lateral tibial condyle

1.5” 20g needle

(Performed with limb unloaded)