Standing Diagnostic Arthroscopy for the Equine Stifle

Key points

• Standing diagnostic arthroscopy has been shown to be well tolerated and without morbidity.
• While the 1.2mm scope has a smaller field of view in comparison to a 4mm scope, diagnostic information has been obtained in the cases where it has been utilized.
• This technique provides diagnostic information not obtainable with other standing techniques and may aid in earlier diagnosis of stifle disease

Diagnosing pain in the stifle has become more common in routine clinical practice. In the authors practice it is the 3rd most commonly treated joint region. However, definitive diagnosis is limited by the inability to accurately image the soft tissue and bone with high sensitivity and specificity. Routine radiography can be helpful in certain cases, many lesions particularly those of soft tissues go undetected. Ultrasonographic examination of the equine stifle joint has helped broaden diagnosis of stifle lesions.1 This is especially true of soft tissue structures, namely the collateral ligaments, patellar ligaments and menisci. Ultrasonographic examination of the cruciate ligaments still poses a problem because of the orientation and deep anatomic location of these structures. Moderate to severe pathology appears to be readily detected using ultrasonography,2, 3 but detection of slight to moderate lesions is difficult.4 Other current methods for diagnostics in the stifle currently require general anesthesia, specifically computed tomography (CT), magnetic resonance imaging (MRI) and routine arthroscopy, which remain the gold standards. It is also worth noting, these latter diagnostics are typically only available at large referral centers, limiting their availability in a more routine practice setting. A recent paper5 details the use of an 18ga disposable arthroscope to safely and efficiently provide complete visualization of the stifle joint in the standing horse and provide another method to diagnose intraarticular stifle disease.  [...]