Arthrography of the equine shoulder joint

Abstract

Summary Techniques and normal radiographic anatomy for positive and double contrast shoulder arthrography in horses were evaluated. General anaesthesia was used for most radiographic projections of the shoulder. The mediolateral projection provided the most information during arthrography, although the supinated mediolateral view occasionally allowed better definition of the cartilage surfaces on the medial aspects of the humeral head. The craniocaudal mediolateral oblique and caudocranial projections provided limited additional information. Water soluble non‐ionic contrast agents, such as metrizamide and iohexol, were suitable for shoulder arthrography; iohexol resulted in less synovitis and lameness. Arthrography in cases of osteochondrosis and osteochondritis dissecans allowed better evaluation of cartilage attachment to subchondral bone, better evaluation of the length and depth of cartilage lesions and more accurately defined the site and shape of osteocartilaginous free bodies. Cartilage thickening without detachment from the subchondral bone could only be determined by arthrography. Although these thick cartilage regions may later dissect from the subchondral bone, most cases where the cartilage was firmly adherent were not candidates for surgical debridement and carried a favourable prognosis. The determination of a free flap by arthrography indicated the need for surgery. Extensive humeral and glenoid cavity lesions were better defined by arthrography, allowing a rational decision between surgical debridement or euthanasia. Using arthrography, evaluation of the size and patency of the communicating canal to a subchondral cystic defect better separated cases with long, narrow and poorly patent canals for conservative rather than surgical therapy.

Computed Tomographic Arthrography of the Intercarpal Ligaments of the Equine Carpus

“…Previous studies using contrast arthrography and CT have described canine stifle joint anatomy and meniscal ligament injury, human carpal and shoulder injury, as well as equine shoulder, stifle, tarsus, fetlock, and carpal anatomy. This imaging technique has been found to have high specificity and sensitivity for documenting stifle joint soft tissue and bone anatomy .…”

Artrografia com meio de contraste positivo e duplo contraste na articulação do úmero de cães

“…No presente estudo, foi adaptada a técnica radiográfica de artrografia com duplo contraste para articulação do úmero de cães a partir de dados coletados na literatura, relatos em humanos (TIELBEEK & VAN HORN, 1983;COOK & TAYAR, 1989) e eqüinos (DIK, 1984;NIXON & SPENCER, 1990). O trabalho avaliou a superfície articular da cabeça do úmero, cápsula articular e porção intra-articular do tendão do bíceps, com o objetivo de produzir uma imagem radiográfica com melhor definição e maior riqueza de detalhes do que aquelas obtidas pela artrografia com MCP utilizada por UNRUH & IWASAKI (2000).…”

“…Em um trabalho utilizando artrografia com duplo contraste na articulação metacarpofalangeana de eqüinos, FACIN (1989) concluiu que a proporção de 20% de MCP, diluído a 50% em água destilada, em relação ao MCN, sendo administrados 6ml de MCP e 30ml de MCN, demonstrava imagem radiográfica que permitia delinear satisfatoriamente as estruturas articulares. Em um estudo com 16 eqüinos, NIXON & SPENCER (1990) Ciência Rural, v.39, n.1, jan-fev, 2009. concluíram que a artrografia com duplo contraste na articulação do úmero produzia uma visualização com maior definição de detalhes nos tecidos moles, como os fundos de saco da cápsula articular, o contorno sinovial, os ligamentos glenoumerais extra-articulares e as bordas lateral e medial da cavidade glenóide.…”

An acute subchondral cystic lesion of the equine shoulder causing lameness

“…The radiographic findings ideally would have been substantiated using intra-articular analgesic techniques (Dyson 1986a), where a significant improvement in the degree of lameness would have been anticipated, although this is not always the case, even when significant joint pathology is present (Dyson 1986c). More specialised diagnostic positive and double contrast arthrography (Nixon and Spencer 1990) may have been beneficial in determining communication of the cyst with the articular surface, and the presence of OCD lesions that may be clinically silent on plain radiography. Unfortunately, general anaesthesia is required in the majority of cases to obtain diagnostic images, therefore arthroscopic evaluation, with or without curettage and debridement as described previously (Bertone 1987;Nixon 1987;McIlwraith 1990) would be the most accurate and informative aid to diagnosis and treatment.…”