Page 129 - Canine Lameness

7.6 Approaches 101

(A) (B)
Figure 7.3 Shoulder: (A) aspirate the shoulder joint by inserting the needle just below the acromion
process in a straight lateromedial direction; (B) alternatively, the joint can also be aspirated by inserting the
needle laterally or medially to the greater tubercle in a caudal direction.

ation of the bony anatomy may be beneficial (to assess the location of the acromion process in
relation to the joint space).
For cranial aspiration (Figure 7.3B), palpate the greater tubercle and insert the needle in a caudal
direction either medial or lateral to this structure. If the needle is inserted medially to the greater
tubercle, the biceps tendon should be palpated and avoided during insertion of the needle.

Video 7.3:

Procedural details for aspiration of the shoulder joint.

7.6.4 Tarsus
The tibiotarsal joint is the most frequently aspirated joint of the tarsus and is generally aspirated
from the cranial or caudal aspect of the joint, approaching from either the medial or lateral side.
The authors prefer the lateral aspect since it is easier to access. Aspiration of the cranial aspect of
the joint (Figure 7.4A and Video 7.4) is done with the tarsus in slight extension and the needle is
inserted into the joint space in a dorsomedial direction beginning at a point just medial and cranial
to the lateral malleolus (distal fibula). Aspiration of the caudal aspect of the joint (Figure 7.4B) is
done with the tarsus in slight flexion and the needle is inserted into the joint space by beginning
needle insertion parallel to the calcaneus with insertion in a craniomedial direction. The tarsus is
a small joint and often a smaller gauge needle may be more appropriate. It is also important to
remember that the cranial and caudal branches of the saphenous vein are located laterally. If pal-
pable, care should be taken to avoid the vein during aspiration. Thorough palpation of joint/land-
marks, prior to aspiration, during range of motion is advised.