Comparison of basilar sesamoidean and distal approaches for synoviocentesis of the forelimb digital flexor tendon sheath in horses

OBJECTIVE To evaluate synoviocentesis of the equine forelimb digital flexor tendon sheath (DFTS) via a basilar sesamoidean approach (BSA) or distal approach (DA). ANIMALS 21 healthy adult horses without DFTS-related lameness. PROCEDURES The forelimbs of each horse underwent the BSA or DA (21 limbs/approach) performed by 1 individual. The volume of synovial fluid (SF) aspirated, time from skin puncture to collection of SF, and number of attempts to place a needle in the DFTS were compared between approaches. RESULTS An SF sample was successfully aspirated from 16 of 21 (76%) limbs with the BSA and 20 of 21 (95%) limbs with the DA. For the BSA and DA, the number of attempts to obtain SF was 2 and 1, respectively; the median volume of SF obtained was 0.4 and 0.7 mL, respectively; and the median time to SF collection was 17.91 and 18.48 seconds, respectively. Between the approaches, the number of limbs with SF successfully aspirated and number of attempts to collect SF differed significantly, whereas the volume of SF aspirated and time to SF collection did not. CONCLUSIONS AND CLINICAL RELEVANCE Regarding SF collection from forelimb DFTSs in horses without DFTS-related disease, use of the DA had a greater success rate with fewer attempts, compared with findings for the BSA, which may reflect the relative ease of identifying anatomic landmarks for the DA. Results suggested that a DA for DFTS synoviocentesis in horses appears efficient and effective and may minimize limb trauma by requiring fewer attempts for SF sample collection, compared with a BSA.