Ultrasound-guided versus palpation-guided intra-articular injection of the canine hip joint

摘要

OBJECTIVE To compare the accuracy of ultrasound-guided versus palpation-guided hip injections in the canine cadaver when ultrasound-guided injections are performed using a caudoventrolateral approach.METHODS Ultrasound-guided and palpation-guided hip injections of coloured liquid latex were performed in 18 canine cadavers by a single operator. A pathologist who was blinded to the procedures dissected the specimens and assessed the injection accuracyfor each hip. Secondary outcome measures also assessed for each technique were: (1) total time taken to complete injection, (2) number of needle repositioning attempts before injection, (3) aspiration of joint fluid, (4) location of any extra-articular injectate relative to the dorsal acetabular rim and ischiatic nerve, and (5) iatrogenic needle damage to the femoral head or sciatic nerve.RESULTS Accuracy for ultrasound-guided and palpation-guided hip injections was 83% (15/18) and 72% (13/18), respectively (difference 11%; 95% confidence interval -9% to 31%; P = 0.16). Time to complete the ultrasound-guided injections was significantly longer than for palpation-guided injections (medians: ultrasound = 70 s, palpation = 40 s, P = 0.0033). Significantly more positive joint fluid aspirations were achieved with ultrasound guidance (ultrasound = 7/18, palpation = 1/18, difference 33%; 95% CI6% to 61%; P = 0.014). Neither technique resulted in iatrogenic damage to the femoral head or sciatic nerve in any of the 18 cadavers.CONCLUSION Accuracy of ultrasound-guided injection of the canine hip joint using a caudoventrolateral approach is not markedly worse than, and is probably similar to or better than, the accuracy of palpation-guided injections when used in canine cadavers.CLINICAL RELEVANCE Given that ultrasound-guided injection may have higher accuracy in live patients, further research is required to compare these techniques in clinical patients.