Comparison of two ultrasound-guided injection techniques targeting the sacroiliac joint region in equine cadavers

John David Stack; Chiara Bergamino; Ruth Sanders; Ursula Fogarty; Antonella Puggioni; Clodagh Kearney; Florent David

doi:10.3415/VCOT-16-03-0041

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2016; 29(05): 386-393
DOI: 10.3415/VCOT-16-03-0041

Original Research

Schattauer GmbH

Comparison of two ultrasound-guided injection techniques targeting the sacroiliac joint region in equine cadavers

John David Stack

¹University College Dublin Veterinary Hospital, Large Animal Surgery, Belfield, Dublin, Ireland

,

Chiara Bergamino

²University College Dublin Veterinary Hospital, Diagnostic Imaging, Belfield, Dublin, Ireland

,

Ruth Sanders

³Chiltern Equine Clinic – Blueberry Farm Hospital, Warfield, Berks, UK

,

Ursula Fogarty

⁴Irish Equine Centre, Co. Kildare, Ireland

,

Antonella Puggioni

²University College Dublin Veterinary Hospital, Diagnostic Imaging, Belfield, Dublin, Ireland

,

Clodagh Kearney

¹University College Dublin Veterinary Hospital, Large Animal Surgery, Belfield, Dublin, Ireland

,

Florent David

⁵Bjerke Dyrehospital en Rikstoto Klinikk, Oslo, Norway

› Author Affiliations

Abstract

Summary

Objectives: To compare the accuracy and distribution of injectate for cranial (CR) and caudomedial (CM) ultrasound-guided injections of equine sacroiliac joints.

Methods: Both sacroiliac joints from 10 lumbo sacropelvic specimens were injected using cranial parasagittal (CR; curved 18 gauge, 25 cm spinal needles) and caudomedial (CM; straight 18 gauge, 15 cm spinal needles) ultrasound-guided approaches. Injectate consisted of 4 ml iodinated contrast and 2 ml methylene blue. Computed tomo-graphical (CT) scans were performed before and after injections. Time for needle guidance and repositioning attempts were recorded. The CT sequences were analysed for accuracy and distribution of contrast.

Results: Intra-articular contrast was detected in sacroiliac joints following 15/40 injections. The CR and CM approaches deposited injectate ≤ 2 cm from sacroiliac joint margins following 17/20 and 20/20 injections, respectively. Median distance of closest contrast to the sacroiliac joint was 0.4 cm (interquartile range [IQR]: 1.5 cm) for CR approaches and 0.6 cm (IQR: 0.95 cm) for CM approaches. Cranial injections resulted in injectate contacting lumbosacral intertrans-verse joints 15/20 times. Caudomedial injections were perivascular 16/20 times.

Limitations: Safety and efficacy could not be established.

Clinical relevance: Cranial and CM ultra-sound-guided injections targeting sacroiliac joints were very accurate for periarticular injection, but accuracy was poor for intra- articular injection. Injectate was frequently found in contact with interosseous sacroiliac ligaments, as well as neurovascular and synovial structures in close vicinity of sacroiliac joints.

Keywords

Ultrasound-guided - horse - sacroiliac - lumbosacral - computed tomography

Full Text

References

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