Palmaroproximal approach for arthrocentesis of the proximal interphalangeal joint in horses.

A technique was developed for arthrocentesis of the palmaroproximal pouch of the pastern joint. The landmark for percutaneous puncture is a 'V' shaped depression formed by the palmar aspect of the proximal phalanx (P1) dorsally, an eminence associated with the attachment of the collateral ligaments to P1 and the middle phalanx distally and the insertion of the lateral branch of the superficial digital flexor tendon palmarodistally. Comparison of arthrocentesis between the palmaroproximal approach and the traditional dorsal approach in 8 cadavers and 8 horses demonstrated that the palmaroproximal approach was associated with less needle manipulation, greater injection volume (horses) and frequent synovial fluid flow.