Joint taps at the same time as XRs?

Re: Joint taps at the same time as XRs?

Niall Connell — Wed, 11 Feb 2015 22:45:19 GMT

[quote user="Elizabeth Billimore"]

I had a dog in today with a massive swollen stifle, non weight bearing for weeks apparently, hardly any range of movement in the stifle, joint effusion and severe DJD on the radiographs. I didn't do any other tests as I wanted to think about the x-rays before making my next move. Looking back I'm thinking I should have probably done a joint tap while the dog was in for x-rays to save the owner having to pay for 2 sedations/anaesthetics.

How do other people decide if it's worth doing joint taps? Is it a case of anything with a swollen joint or joint effusion that is not obviously due to something like CCL ruture or OA? Do people tend to do joint taps under GA or sedation?

[/quote]

I would routinely perform joint taps on swollen joints under anaesthetic or sedation at the same time as doing radiography. I have done an occasional conscious joint tap if the patient is relaxed. I loved the feeling of satisfaction when I palpated a bulging anconeus muscle in a dog's elbow and then aspirated pus!

Re: Joint taps at the same time as XRs?

Hannah Wynne Richards — Wed, 11 Feb 2015 15:05:23 GMT

I don't think I've ever done one in a small animal. Takes me back to mixed practice days, and joint ill.

Wynne

Re: Joint taps at the same time as XRs?

Utlendigur — Tue, 10 Feb 2015 19:00:52 GMT

[quote user="Elizabeth Billimore"]How do other people decide if it's worth doing joint taps? Is it a case of anything with a swollen joint or joint effusion that is not obviously due to something like CCL ruture or OA?[/quote]

Pretty much. Things like cases that are pyrexic (? septic arthritis), or shifting lameness (? polyarthritis), joints that just don't look quite right eg odd changes or much more severe than expected, sometimes done to try to identify the problem joint causing lamenes where nothing obvious on clinical exam or xray etc

[quote user="Elizabeth Billimore"] Do people tend to do joint taps under GA or sedation?[/quote]

Depends on the animal and the joint. If you've got a big joint space to aim for, eg stifle, and the animal's well sedated I'd go ahead, otherwise GA

Also not an orthopod

Re: Joint taps at the same time as XRs?

Rob Davis — Tue, 10 Feb 2015 18:07:58 GMT

Hindsight is always twenty-twenty as they say....

I do joint taps more often than I used to, but still not probably as often as I should. They are generally quick, safe, easy and cheap. It is probably sensible to tap any swollen or sore joint in which you can't see an obvious explanation. Usually I will do this under GA at the same time as radiography, but I have one GSD with a variety of ailments including chronic immune-mediated polyarthritis who I tap fairly regularly under dom/torb sedation. If in any doubt I generally prefer to GA to avoid any unexpected movement.

NB I am not an orthopod by any stretch of the imagination, so hopefully those with more orthopaedic knowledge will chip in too.