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Lameness in Horses in Exam 2 > Bone Lameness > Flashcards

Bone Lameness Flashcards

1
Q

What are the ways you should think about disease?

A

○ Definition of term(s)
○ Cause
§ Pathology
○ Clinical signs
○ Diagnosis
○ Treatment
○ Prognosis
○ Prevention

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2
Q

What is periostitis?

A

○ Bone bruising or contusion
§ Inflammation of the periosteum

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3
Q

What are the causes of periostitis?

A

direct trauma

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4
Q

What are the signs of periostitis?

A

pain on direct pressue

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5
Q

What is the diagnosis of periostitis?

A

subjective

radiographs, CT, MRI

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6
Q

What is the treatment of periostitis?

A

rest, cold hosing, bandaging, NSAIDs

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7
Q

What are bucked shins?

A

types of periostitis

thickening of the bone cortex: dorsal MCIII and MTIII

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8
Q

What is the signalment of bucked shins?

A

young (2-3 y.o.) fast-gaited horses

thoroughbreds, quarter horses, and standardbreds

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9
Q

What are the causes of bucked shins?

A

increased strain on developing bones

body responds with bone remodeling

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10
Q

What are the signs of bucked shins?

A

swelling and pain upon palpation
worse after exercise or race

often bilateral (L>R)

variable lameness

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11
Q

What are diagnosis of bucked shins?

A

clinical findings and signalment

imaging
radiographs
thermography
nuclear scintigraphy
AKA bone scan

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12
Q

What are the treatments of bucked shins?

A

catch early: rest with hand-walking, decrease training

mild: NSAIDs, cold hosing, bandaging with DMSO

moderate to severe: shockwave, electrical stimulation, laser therapy, magnets, intralesional steroid injection, thermocautery (pin firing), chemical vesication (blistering), cryotherapy (point freezing)

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13
Q

Which kind of horses develop dorsal cortical pain?

A

80% of 2 y.o. TBs develop dorsal cortical pain

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14
Q

Who develops a dorsal cortical fracture of MCIII?

A

12% of TBs develop dorsal cortical fracture

stress fracture

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15
Q

How might you treat a dorsal cortical fracture of the MCIII?

A

surgical screw and drilling (osteostixis)

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16
Q

What is osteitis?

A

inflammation involving periosteum and cortex

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17
Q

What is osteomyelitis?

A

inflammation involving periosteum, cortex, and medullary cavity

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18
Q

What is pedal osteitis?

A

pedal = PIII

inflammation reaction localized along solar margin of PIII
can cause bone demineralization

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19
Q

What are the causes of pedal osteitis?

A

constant concussive trauma, laminitis, navicular syndrome, sole abscess

usually associated with animals exercised over hard service

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20
Q

What are the signs of pedal osteitis?

A

reluctant to extend stride

often bilateral

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21
Q

What is the diagnosis of pedal osteitis?

A

hoof testers: positive along the solar margin

palmar/plantar digital (PD) or abaxial nerve block

radiographs

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22
Q

How do you treat pedal osteoitis?

A

proper hoof trimming and corrective shoeing: keel sole away from ground

medications: isoxsuprine, NSAIDs

palmar digital neurectomy: chronic disease

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23
Q

What is infectious osteitis?

A

There is both bacteria and inflammation in the periosteum and cortex

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24
Q

What causes infectious osteitis?

A

break in skin

Nearby septic process

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25
Where is infectious osteitis found?
common in distal extremities of horse sparse soft tissue coverage metacarpal/metatarsals
26
What is sequestrum?
piece of dead bone often from local trauma
27
What is required for infectious osteitis with sequestrum?
need avascularity and infection not just blunt trauma infection comes from break in skin or systemically develop draining tract often need to be removed surgically
28
What are the signs of infectious osteitis?
severity of lameness variable sensitive to palpation +/- draining tract
29
How do you diagnose infectious osteitis?
radiographs initially: soft tissue swelling 1-2 weeks: periosteal proliferation 2-3 weeks: sequestrum visible
30
How do you treat non-infectious osteitis?
rest, cold hosing, NSAIDs
31
How do you treat infectious osteitis with sequestrum?
surgical removal of sequestrum with debridement of bone and necrotic tissue antibiotics: systemic often fail, can try regional limb perfusion
32
What is osteomyelitis?
more extensive inflammation of bone begins within or extends into medullary cavity
33
What are the 3 categories of osteomyelitis?
hematogenous traumatic iatrogenic
34
What is hematogenous osteomyelitis?
primary in neonates, rarely in adults
35
What is traumatic osteomyelitis?
usually from penetrating wound or open fracture
36
What is iatrogenic osteomyelitis?
surgery - internal fixation of fractures intra articular injection of medications
37
What are the signs of osteomyelitis?
pain on palpation fever (foals) lameness soft tissue swelling ineffective wound healing
38
How do you diagnose osteomyelitis?
radiographs: bone lysis (10-14) days after insult, sequestrum formation, bone thickening
39
How do you treat osteomyelitis?
antibiotics: systemic, regional limb perfusion, placement of antibiotic infused beads NSAIDs surgical debridement of affected bone
40
What is overriding/impingement of dorsal spinous process
AKA kissing spines most common location: T5-T18 often show jumpers and hunters
41
What is the cause of overriding/impingement of dorsal spinous process?
repetitive contact between dorsal processes
42
What are the signs of kissing spines?
mobility: reduced ventrodorsal mobility from impingement, limited lateral mobility from muscle spasm palpation: irregularity of dorsal spinous process, pain with localized digital pressure
43
How do you diagnose kissing spines?
palpation local anesthetic radiographs: bony changes ultrasound: contact, remodeling, abnormal ligament nuclear scintigraphy: active bone remodeling, remodeling
44
How do you treat kissing spines?
rest NSAIDs local injections: corticosteroids, sarapin acupuncture shockwave surgical removal of affected spinous processes
45
What is an interspinous ligament desmotomy (ISLD)
surgically transect interspinous ligament physical therapy
46
What are bone tumors?
primary bone neoplasia rare in horses more common in skull, but can occur in limbs
47
What are fractures?
bone loses structural continuity function impaired to some degree
48
What is the severity of lameness from fracture determined by?
bone fracture level of function impaired SHOULD ALWAYS BE ON DDX FOR NON-WEIGHT BEARING LAMENESS
49
How do you diagnose a fracture?
clinical signs: crepitus (cracking sound), deviation of limb, open fracture imaging: radiographs, ultrasound, bone scan, computed tomography (CT), magnetic resonance imaging (MRI)
50
What are the goals in stabilizing and immobilizing a fracture?
minimizes further damage maintain limb in proper position and condition to facilitate repair
51
What does splint or bandage application do for fractures?
immobilize joint above and below
52
What are external fracture fixations?
casts fixators
53
What are internal fraction fixations?
screw: lag, cortical bone plates wires intramedullary pins
54
How do you come up with fracture prognosis?
depends on: bone affected fracture characteristics: articular vs non-articular, simple vs comminuted (bomb goes off) horse's temperature horse's age and size expertise of surgeon
55
What are the signs of humeral fractures?
non-weight bearing forelimb appears shorter
56
How do you treat humeral fracture?
bone plating stall rest
57
What are signs of radial fractures?
non-weight bearing valgus limb because of lateral musculature
58
How do you treat radial fractures?
sx- bone plate, pins cast
59
Who usually gets olecranon fractures?
foals
60
What are signs of olecranon fractures?
non-weight bearing dropped elbow
61
How do you treat olecranon fractures?
rest, bandage sx- bone plate
62
What are chip fractures?
found in carpal one articular surface partially attached or loose within a joint often radial carpal bone
63
what are slab fracture
usually found in carpal two articular fractures often 3rd carpal bones
64
What are signs of carpal fractures?
moderate to severe lameness
65
How do you diagnose carpal fractures?
radiographs - flexed lateral, skyline
66
How do you treat carpal fractures?
surgery - arthroscopic for chips, lag screw for slab
67
Where are cannon fractures found?
MCIII>MTIII
68
Where are transverse cannon found?
mid-cannon 50% open immobilize with Robert Jones bandage
69
Where are condylar cannon fractures found?
distal and lateral articular
70
What are signs of cannon fractures?
moderate to non-weight bearing articular - positive flexion, effusion
71
How do you treat cannon fractures?
surgery transverse - bone plate condylar - lag screw casting after surgery
72
Where are splint bone fractures found?
distal third fx > upper and middle fx
73
What are the signs of splint bone fractures?
variable
74
What are the treatments of splint bone fractures?
conservative - rest, bandage surgery: remove up to 80%
75
What are the complication of splint bone fractures?
suspensory desmitis sequestrum callus
76
Describe a chip PI fracture
often dorsal eminence just medial to midline
77
Describe a sagittal PI fracture
fetlock and pastern joints involved
78
What are the signs of PI fractures?
variable lameness articular - effusion, positive flexion
79
How do you treat PI fractures?
sx - chip removal, lag screws for sagittal
80
What often happens to PII fractures?
often communited
81
How do PII fractures happen?
combination of compression and torsion PI often involved
82
What are signs of PII fractures?
variable lameness
83
What are treatments of PII fractures?
sx - bone plate, arthrodesis casting
84
What are the type of PIII fractures?
wing, articular wing, sagittal articular fractures, extensor process fractures, comminuted articular and nonarticular, chip
85
Describe PIII wing fractures
most common, nonarticular, oblique across palmar process
86
Describe articular wing PIII fractures
oblique across palmar process, enters joint
87
Describe sagittal articular PIII fractures
from joint distally, dividing bone into two even halves
88
Describe extensor process PIII fractures
occur at site of insertion of digital extensor tendon
89
Describe comminuted articular and nonarticular PIII fractures
numerous fracture lines
90
Describe chip fractures of the PIII
nonarticular, solar margin
91
What are the signs of PIII fractures?
acute onset moderate to severe lameness increased digital pulse and heat
92
How do you diagnose PIII fractures?
hoof testers - PAINFUL! PD or abaxial nerve block rads, CT
93
How do you treat nonarticular PIII fractures?
immobilize fracture, prevent expansion of hoof bar shoe with quarter clips or foot cast 6-8 months with resets every 4-6 weeks
94
How do you treat articular PIII fractures?
surgery with internal fixation: complication of infectious osteitis because hard to disinfect these tissues prior to surgery palmar digital neurectomy if still lame after sx
95
What are the types of proximal sesamoid fractures?
apical (most common) abaxial (least common) basal mid-body comminuted
96
What are the signs of proximal sesamoid fractures?
acute severe lameness
97
What is the treatment for proximal sesamoid fractures?
stall rest, cast surgery: surgical excision (<1/3 of bone), lag screw fixation, circumferential wiring
98
What predisposes distal sesamoid fractures?
navicular syndrome, predisposing cause of foot chip fx
99
What are the signs of distal sesamoid fractures?
non-specific foot lameness
100
How do you diagnose distal sesamoid fractures?
hoof testers, PD nerve block radiograph
101
How do you treat distal sesamoid fractures?
PD neurectomy
102
Describe pelvic fractures
often unilateral and involve multiple bones
103
What are the signs of pelvic fractures?
acute severe lameness toe out, hock in
104
How do you diagnose pelvic fractures?
rads, U/S (ultrasound) rectal exam
105
How do you treat pelvic fractures?
sling, stall rest, NSAIDs euthanasia
106
What is the prognosis of an acetabular fracture?
poor prognosis
107
What are the signs of a femoral fracture?
non-weight bearing limb appears short, hock held higher
108
How do you treat femoral fractures?
euthanasia - most adults sx - intramedullary pin, bone plate
109
What is the prognosis of a femoral fracture?
very poor if > 1 y.o.
110
What are the signs of a patellar fracture?
acute non-weight bearing
111
What are the treatments of non-articular patellar fractures?
stall rest and NSAIDs
112
How do you treat articular patellar fractures?
surgical excision if <1/3 of bone internal fixation
113
What are the signs of tibial fractures?
non-weight bearing anxious, sweating
114
How do you treat tibial fractures?
euthanasia - most adults sx with internal fixation - young
115
Describe tarsal fractures
slab fractures central and third tarsal bones
116
What are the signs of tarsal fractures?
acute lameness effusion, positive flexion
117
What is this a picture off?
Periostitis
118
Bucked shins
119
bucked shins
120
Bucked shins
121
nuclear scintigraphy of bucked shins
122
dorsal cortical fracture of MIII
123
bone inflammation
124
hoof tester
125
normal coffin bone
126
pedal osteitis
127
pedal osteitis
128
infectious osteitis with sequestrum
129
kissing spines
130
normal (L) and kissing spine (R)
131
olecranon fracture
132
carpal fracture
133
cannon fracture
134
Describe the types of PIII fractures
135
Describe proximal sesamoid fractures
136
describe the distal sesamoid fractures
137
Describe heat view of fractured tibia

Lameness in Horses in Exam 2 (3 decks)

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