Arthritis

Question 1

Radiographic signs of arthritis?

Answer 1

Soft tissue swelling 
Osteophytosis
Enthesiophytosis
Sub chondral bone sclerosis
Intra-articular mineralisation 
Intra-articular fragments
Collapsed joint space
Subchondral bone cyst

Question 2

How can you manage OA?

Answer 2

Rest in acute flare ups
Exercise beneficial long term
Cold therapy and massage
Weight loss

Question 3

How can you medically manage OA?

Answer 3

NSAIDs - PBZ / suxibuzone
Intra-articular steroids - methylprednisolone acetate 
Hyaluronic acid
Autologous conditioned serum - IRAP
Bisphospohonates - ihibit osteoclastic activity 
 - navicular disease
 - small tarsal OA 
Monounsaturated fatty acids
Glucosamine / chondroitin sulphate 

Pentosan polysulphate soidum - cartrophen - CI with NSAID

Question 4

What surgical management options are available for OA in the horse?

Answer 4

Arthroscopy

Arthrodesis - pastern + small tarsal joints

Question 5

What is the aetiology of septic OA in the horse?

Answer 5

Haematogenous - foals with FPT
Traumatic - adults with wounds over a joint
Iatrogenic

Question 6

What are the characteristics of normal synovial fluid?

Answer 6

Yellow
Viscous 
WBC count - less than 1x10^9
Total proteins - less than 20 g/L
Less than 10% neutrophils

Question 7

What sample tubes should you collect synovial fluid in?

Answer 7

EDTA - WBC count and total protein

Plain - culture

Question 8

What are the features of septic synovial fluid?

Answer 8

Serosanguinous 
Turbid
Reduced viscosity
Total proteins 30-40g/L
More than 90% neutrophils

Question 9

How can you treat septic arthritis in the horse?

Answer 9

Antimicrobial - broad spectrum initially, then based on C&S
- broad spectrums - penicillin, metronidazole, gentamycin
- intra-articular - aminoglycoside - Amikacin
- IV regional perfusion - gentamycin
Flush joint
- through and through needle lavage
- arthroscopy

Chronic sepsis - arthrotomy