Intra-articular anesthesia

• Intra-articular anesthesia is an infrequently performed technique in cattle.
• It can be used to identify the site of lameness in individual cattle as well as providing analgesia.
• Used to attempt to manage septic arthritis in cattle.

Uses

• Lameness diagnosis.
• Management of osteomyelitis.
• Analgesia.

Advantages

• Ability to localise pain to joint, tendon sheath or bursae.
• Can provide long-term analgesia.

Disadvantages

• Inconsistent in abolishing pain in some articular problems, particularly in chronic disease.
• Requires strict aseptic technique.
• Requires skilled personnel.
• Theoretically toxic to articular cartilage.

Technical problems

• Risk of joint sepsis or secondary synovitis from intra-articular injection.
• Difficulty of needle placement into some synovial structures.

Alternative techniques

• Perineural anesthesia.
• Other forms of  lameness diagnosis, eg palpation, radiography, ultrasonography.

Time required

Preparation

• The time it takes to clip/shave site, to get equipment ready and to aseptically prepare the site for injections (approx. 5 min).
• Suitable restraint to prevent injury to cow and veterinary surgeon eg leg tied up in crush. Cattle restraint techniques

Decision taking

Criteria for choosing test

• Limb palpation.
• Examination of gait.
• Response to hoof testers or flexion tests.

Risk assessment

• Assess patient compliance with intra-articular injection.
• Risk of iatrogenic septic arthritis secondary to injection.