Page 385 - The Veterinary Care of the Horse

and thickening of the synovial membrane.

VetBooks.ir ARTHROSCOPY

Arthroscopy under general anaesthesia allows direct inspection of the articular cartilage, the
synovial membrane and the joint fluid. It allows confirmation of the diagnosis and may be

part of the treatment protocol. A biopsy of synovial membrane may be taken.

BLOOD TESTS

Blood may be taken for haematology. The horse’s total white cell count may be raised with
an increased percentage of neutrophils. The plasma fibrinogen may also be raised. However,

these changes may not occur until several days after the joint infection has become
established. The exception is serum amyloid A which increases rapidly in response to

infection and inflammation.

INJECTION INTO THE JOINT TO CHECK FOR LEAKAGE

It is not always easy to tell whether a wound directly over a joint has breached the joint

capsule. In these cases, it can be helpful for the vet to inject sterile fluid into the joint at a site
well away from the contaminated area, to see if the fluid then leaks from the wound.

Treatment

Early diagnosis and prompt treatment have a big influence on the outcome of joint infections.
The aim of treatment is to remove the bacteria and the harmful inflammatory products along

with any foreign material.

Treatment may include the following.
• Immediate intravenous injection of broad spectrum antibiotics while awaiting the results

of bacterial culture and antibiotic sensitivity.
• Joint lavage (flushing out) and drainage, usually best performed under general

anaesthesia. This removes the inflammatory mediators and also fibrin clots and other
debris which may have bacteria trapped inside and therefore protected from the

antibiotics.
• Debridement (surgical removal) of any infected or damaged articular cartilage and bone.

This may be done arthroscopically or via an arthrotomy (open joint surgery) incision.
Any infected or severely damaged synovial membrane can be removed at the same time.

The advantage of looking inside the joint with the arthroscope is that the damage can be
seen and dirt and debris removed.