Background: There is conflicting evidence regarding communication between the two compartments of the equine temporomandibular joint (TMJ). Understanding the inter-relationship between TMJ compartments is critical for diagnostic and clinical management purposes.Objective: To determine the frequency of communication between the discotemporal joint (DTJ) and the discomandibular joint (DMJ) of the equine TMJ in horses free of overt disease.Study Design: A randomized, blinded, controlled cadaveric study.Methods: Equine cadaver heads (n = 20), with no reported history of potential TMJ disease, were collected and stored frozen until use. Horses were randomized to the treatment group, such that Group A horses (n = 10) underwent arthrocentesis of the left DTJ and the right DMJ compartments, while Group B (n = 10) underwent arthrocentesis of the left DMJ and the right DTJ compartments of the TMJ, for a total of 40 joints. Computed tomography (CT) imaging was performed before, and after, intra-articular injection of contrast media in each head. Two observers, blinded to the treatment group, independently interpreted CT images.Results: Communication between synovial compartments occurred in the left TMJ of two horses. Arthroscopic evaluation revealed that both horses had a perforation of the intra-articular disc in the region of the caudomedial fibrous expansion. Mild anterior displacement of the abnormal disc in the joint of one horse was demonstrated using magnetic resonance imaging (MRI).Main Limitations: Sample size, the use of owner provided animals' history, and frozen specimens.Conclusions: No physiological communication was present between the DTJ and the DMJ in the equine TMJ of the cases studied, regardless of which compartment underwent arthrocentesis. Two joints had pathological communications. These results suggest that diagnostic, and medical, treatment of intra-articular disease may be most effective when both joint compartments are injected. Furthermore, this study illustrates the value of contrast enhancement while imaging the equine TMJ.
Background:Definitive diagnosis of equine temporomandibular joint osteoarthritis (TMJ-OA) may require advanced diagnostic imaging. Arthroscopy is a modern, minimally invasive, diagnostic, and treatment modality. Standing arthroscopic treatment of joint disease is a relatively recent advance in equine surgery, despite which there are few published comparisons between the available arthroscopic systems.ObjectiveTo compare and contrast two arthroscopic systems for assessing the equine temporomandibular joint compartments in cadavers and standing horses.Study designExperimental study.MethodsPhase I involved the assessment of the discotemporal joint (DTJ) and discomandibular (DMJ) joint compartments of both temporomandibular joints (TMJ) of 14 cadaveric equine heads using a caudally placed arthroscopy portal. Joints were initially examined using the needle arthroscope and the results compared to the findings of examination using a 2.5 mm 30° arthroscope system (standard). Three healthy horses were subsequently examined to determine the validity of the procedure in live animals in Phase II.ResultsNeedle and standard arthroscopy, in combination with mandibular manipulation, allowed evaluation of the caudal aspects of both joint compartments of the TMJ in Phase I. However, the extreme margins of the joint were more commonly visualized using standard arthroscopy. Live horses in phase II were restrained in stocks and both the rostral and caudal aspects of the DTJ and DMJ compartments of both TMJs were examined successfully understanding sedation and local analgesia. The use of a modified Guenther speculum allowed the mandible to be manipulated and offset, which facilitated a complete examination of the joint compartments. Despite adverse behavior encountered during the procedure in one horse, no surgical complications ensued.Main LimitationsNot blinded—bias; learning curve.ConclusionsThe needle arthroscope system is a relatively inexpensive diagnostic tool, which can be used to evaluate the TMJ in the absence of advanced diagnostic imaging such as computed tomography or magnetic resonance imaging. However, if arthroscopic treatment is required after advanced imaging and pre-operative diagnosis, superior image quality and ease of manipulation may favor the use of the standard equipment.
A 15-month-old Quarter Horse filly presented for evaluation of hard swellings over the left temporomandibular joint (TMJ) and the right metatarsophalangeal joint (MTPJ). The TMJ swelling had been noted since she was weaned at 4 months of age and had slowly enlarged since then. Radiographs of both TMJs and the right MTPJ were performed, which revealed severe osteoarthrosis associated with osteochondrosis-like lesions. The filly was subjected to euthanasia due to the poor prognosis for performance. Computed tomography and post-mortem examination, including histopathology of the left TMJ, revealed early osteoarthritis (OA) associated with osteochondrosis-like lesions of the left TMJ and the right MTPJ, while the right hind proximal interphalangeal joint (PIPJ) was diagnosed with early OA.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.