Comparison of three methods of injecting the proximal interphalangeal joint in horses

The efficacy of three methods of injecting the equine proximal interphalangeal (pastern) joint was compared using cadaver limbs. Five veterinary students without prior experience attempted to inject an aqueous radiographic contrast medium into the joint using five limbs for each technique. The number of attempts was recorded and successful injection of the joint was confirmed by the presence of intra-articular contrast on radiographic examination. Levels of accuracy for the dorsal, dorsolateral and palmaroproximal approaches were 32, 48 and 36 per cent, respectively. There was inadvertent injection of the digital flexor tendon sheath using the palmaroproximal approach in 64 per cent of injections. The dorsolateral approach was associated with fewer needle manipulations.