Bone Pathologies in Horses Flashcards
What is periosteal new bone formation?
- Blunt trauma can lead to sub-periosteal haemorrhage
- Lifting of Periosteum away from the bone
- Stimulates production of periosteal new bone
- Initially less dense and irregular outline
- Becomes more radiopaque with a smooth outline
What is sclerosis?
- Densification
- Localised formation of new bone within bone
- Stress
- Protection of a weakened area
- Walling off infection
What is bone lysis?
Destrcution in an area of bone
(infection, Neoplasia, Keratoma)
What is osteophyte formation?
- Spur of bone on a joint margin
- Joint instability
- Intra-articular disease (e.g OA)
What is enthesophyte formation?
New bone formation at attachment of a tendon/ ligament/ joint capsule to bone
What is aggressive bone disease?
- Destrcution of the cortex
- Character of the periosteal reaction
- Lack of distinctness of boundary between the bone lesion and normal bone
What is ultrasonography useful for?
Used to assess the surface of bone
Bone surface should appear smooth and have uniform thickness of a hyperechoic line
How would you use nuclear scintigraphy?
Radioisotope (Technetium 99m) is injected intravenously
➢ Increased Radiopharmaceutical Uptake (IRU) in areas where there is increased osteoblastic activity
➢ High sensitivity but low specificity imaging modality
What are the indications of nuclear scintigraphy?
Fracture suspected but no localising clinical signs and negative radiographs
* To assess animals with obscure lameness issues
* Unable to localise with diagnostic analgesia, episodic lameness
* Evaluate horses with poor performance
* Evaluate inaccessible areas e.g pelvic region in the horse
What is valgus?
Lateral deviation of limb
What is varus?
medial deviation of the limb
What is the non-surgical way of treating angular limb deformities?
rest, splints and casts, bandages, hoof manipulation
What is the surgical way of treating angular limb deformities?
- Periosteal stripping to stimulate growth
- Growth retardation by bridging the growth plate
What is physitis?
Inflammation of the growth plate
What is a sequestrum?
Piece of dead radiopaque bone
What is involucrum?
Surrounded by an area of lucent granulation tissue
What is the sinus?
Radiolucent tract between infected bone and skin
How would you treat osteitis and osteomyelitis?
Systemic antimicrobial therapy
Analgesia
Wound care
Curattege
Implant removal
What is the prognosis of osteitis and osteomyelitis?
Variable, depends on the severity and chronicity of infection
What is the purpose of scintigraphy
- assess areas of increased bone turnover around the joint
- subchondral stress related bone injury
- early diagnosis of OA
What is MRI used to assess?
used to assess concurrent soft tissue damage which may be resulting in joint instability
What is a contrast study?
- Contrast agent injected into joint and radiographs are taken
What is a pressure test?
Distend the joint with sterile saline
* Saline exits through the wound if joint and wound communicate
What is the purpose of arthroscopy?
Allows direct visualisation of the joint
* Diagnostic and therapeutic
What are the 4 aims of OA management?
- Provide analgesia
- Control articular inflammation
- Limit damage to articular tissues
- Promotes healing of damaged cartilage
What is the physical therapy for osteoarthritis?
- Acute = rest, cold therapy
- Chronic= gentle exercise, hydrotherapy
What is the anti-inflammatory/ analgesia treatment for osteoarthritis?
- Non-steroidal Anti-Inflammatory drugs
- Most commonly used treatments
- Toxicity concerns
What are corticosteroids used for?
- Intra-articular
- Reduction in inflammation in the joint
- May cause laminitis so take care
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What are the three adjunctive treatments?
- Hyaluronic acid
- Pentosan Polysulphate Sodium
- Biphosphates
What is the pathogenesis of septic arthritis?
- Inflammatory response
- Fibrin clot then traps bacteria
- Cartilage destruction and extension to the subchondral bone
- Results in pain and swelling of the affected joint -> Ultimately leading to degenerative osteoarthritis
