Ultrasonography is the veterinarian’s second-most-used diagnostic imaging device and essential for equine practitioners. Thinking past the modality’s conventional makes use of for gentle tissue harm prognosis and being pregnant monitoring, ultrasonography additionally presents nice potential to information and help veterinarians in precisely performing invasive procedures.

At the 2022 Veterinary Meeting and Expo (VMX), in Orlando, Florida, Betsy Vaughan, DVM, Dipl. ACVSMR, shared examples of situations the place ultrasound steerage—holding the needle in a single hand and the transducer within the different—makes procedures safer, extra correct, and fewer traumatic for the equine affected person.

 Vaughan, a scientific professor of enormous animal ultrasound on the University of California, Davis, School of Veterinary Medicine, stated, in her expertise, ultrasound-guided veterinary procedures provide three foremost benefits:

Accessing hard-to-reach buildings that have to be injected.

“When performing injections, synovial cavities located deep under thick layers of skeletal muscle, such as the coxofemoral (hip) joint, are difficult to visualize and access without utilizing ultrasound guidance,” she stated. “Likewise, the articular facet joints of the cervical spine, the bicipital bursa of the shoulder, and the navicular bursa are all synovial structures that can benefit from ultrasound-guided injections.”

Providing exact, correct, atraumatic penetration into difficult-to-palpate buildings.

When injecting a lesion within the suspensory ligament, for instance, the standard or “blind” strategy dangers puncturing the deep digital flexor tendon (DDFT) and adjoining blood vessels and nerves. Adding ultrasound to the image permits veterinarians to take an indirect (on this case plantolateral) strategy to the suspensory ligament, sparing adjoining tendons, ligaments, vessels, and nerves.

“Similarly, the navicular bursa can be injected without penetrating the DDFT by taking a lateral approach using a small microconvex ultrasound transducer to guide the needle,” Vaughan added. “This transducer has the added advantage of being small and curved, so it fits in tight spots such as the heel bulb region without interfering with needle placement.”

If the navicular bursa or one other synovial construction turns into septic, ultrasound imaging turns into particularly invaluable in sampling synovial fluid. “In septic joints, bursae, and tendon sheaths, the lining (synovium) is severely inflamed and thickened, with little accessible synovial fluid,” Vaughan defined. “Blind techniques are often unrewarding for this reason and risk further trauma and/or hemarthrosis (bleeding into the joint capsule) with too many attempts or when too much pressure is applied during aspiration. In addition to being painful to the horse, this has the potential to delay diagnosis.”

Offering visible steerage in surgical procedure.

In the working room, ultrasound steerage carries the potential to make surgical debridement as atraumatic as doable. “We can use the technology to examine a wound that needs to be debrided, assess internal abscesses and adjacent structures before lancing, and evaluate bone fragments before surgical removal,” Vaughan stated. “In areas with thick, dense overlying musculature, ultrasound can be used to help guide the placement of surgical instruments.”

There’s extra to ultrasound-guided procedures than their sensible benefits: “We also see the doctor-client relationship benefit,” Vaughan stated. “There’s a high perception of value for the horse’s owner watching in real time their investment (the injectate) land exactly where it’s supposed to in their animal’s joint or lesion. Thanks to ultrasonography, both veterinarian and client gain the reassurance that the treatment is placed where it’s meant to be.”

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