Page 130 - Canine Lameness

102 7 Arthrocentesis Technique

Figure 7.4 Tarsus: (A) aspirate the tarsal
joint cranially by inserting the needle in a
dorsomedial direction beginning at a
point just medial and cranial to the
lateral malleolus, or (B) caudally by
inserting the needle in a craniomedial
direction.

(A) (B)

Video 7.4:

Procedural details for aspiration of the tarsal joint.

7.6.5 Stifle
The stifle is a large joint that can be aspirated in several ways, depending on clinician preference.
It is aspirated either medially (Figure 7.5A and Video 7.5) or laterally (Figure 7.5B) to the patellar
tendon. Some clinicians prefer to insert the needle through the central portion of the patellar liga-
ment and one of the authors (BT) has not noticed any adverse events using this approach. In all
cases, the joint is held in mild flexion. If aspiration is to occur medial or lateral to the patellar ten-
don, it may help to palpate the femoral condyle and the joint pouch and push fluid from the side
opposite of where aspiration is to occur. Aspiration is performed by first locating the point for
needle insertion, which is typically halfway between the patella and the tibial tuberosity. The nee-
dle is then inserted in a craniocaudal direction and angled toward the intercondylar space of the
distal femur. A longer (1.5″) needle is ideal for the stifle. Due to the fat pad, joint fluid may be dif-
ficult to aspirate particularly in a normal joint because it contains little joint fluid.

Video 7.5:

Procedural details for aspiration of the stifle joint.

7.6.6 Hip
The coxofemoral joint is most commonly aspirated from the lateral side of the body. The limb is
placed in slight abduction and the joint is identified by palpating the greater trochanter (illustrated
in Figure 7.6). A long needle should be used and inserted just proximal to the greater trochanter at