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OBJECTIVE To develop a technique for standing diagnostic needle arthroscopy of the radiocarpal and middle carpal joints in standing sedated horses. STUDY DESIGN Experimental study. ANIMALS Six cadaveric forelimbs (phase 1) and six healthy horses (phase 2). METHODS In phase 1, six cadaveric forelimbs were used to assess needle arthroscopic evaluation of both joints. Six healthy horses were subsequently enrolled in phase 2 to validate the procedure in live animals. The joint was maintained in flexion with a custom-made splint and base.