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Eq SX Musc Skel Exam > Carpus-Biedrzycki > Flashcards

Carpus-Biedrzycki Flashcards

1
Q

Diseases of the carpus

A
  1. Synovitis (esp racehorses)
  2. Intra-articular carpal bone fractures
  3. Accessory carpal bone fractures
  4. Subchondral bone cyst like lesions (SBCs)
  5. Luxation
  6. Carpal hygroma
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2
Q

Joints of the carpus

A
  1. Radiocarpal joint (RCJ)
  2. Middle carpal joint (MCJ)
  3. Carpometacarpal joint
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3
Q

Proximal row of carpal bones

A
  1. radial carpal bone
  2. ulnar carpal bone
  3. intermediate carpal bone
  4. accessory carpal bone
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4
Q

Distal row of carpal bones

A
  1. 1st 2nd
  2. third
  3. fourth
  4. Sometimes fifth
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5
Q

Things that communicate

A
  1. RCJ and MCJ communicate ~ 5% cases
  2. RCJ and carpal sheath communicate ~ 5% cases
  3. MCJ and CMC communicate 100% of the time
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6
Q

Common carpal injuries in foals

A
  1. Cuboidal bone hypoplasia and collapse
  2. Sepsis
  3. Osteomyelitis
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7
Q

Common yearling injuries

A

osteochondral chip fragment

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8
Q

Common adult injuries

A

Ush racehorses

  1. osteochondral chip fragmentation
  2. SBCs
  3. Palmar intercarpal desmitis
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9
Q

Osteochondral chip frag etiology

A
  1. Weightbearing is dorso-medial (RCB, C2, C3 at greatest risk)
  2. Submaximal stress remodeling
    - Trauma during exercise-subchondral sclerosis
    - microfractures or gross fractures
  3. Supra maximal trauma
    - fracture
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10
Q

Predispositions to carpal fractures in racehorses

A
  1. Conformation (back at the knee)
  2. Muscle fatigue in untrained horses/end of exercise
  3. Racing ground type
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11
Q

Due to racing direction in states

A

lateral aspect of left carpus frequently affected

medial aspect of right carpus frequently affected

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12
Q

Slab fractures are

A

bi-articular

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13
Q

Radiographs

A

Standard 4 views
Flexed Lateromedial
Skyline of proximal and distal rows

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14
Q

CS

A
  1. joint effusion
  2. pain on flexion
  3. IA anesthesia in chip fractures ONLY
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15
Q

OC frag TX

A

Prompt surgical removal to maximize prognosis

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16
Q

Prognosis

A
  1. Depends on degree cartilage loss
  2. Age of fracture
  3. Presence of DJD
    70-80% return to racing
17
Q

Slab fracture tx

A

Requires internal fixation
65-75% return to previous performance level
Standardbreds slightly better prognosis than TBs
Pancarpal arthrodesis is salvage and last resort

18
Q

Accessory carpal bone fractures

A
  • Usually vertical fissure along lateral groove of ulnaris lateralis m
  • treatment is conservative or surgical, end result fibrous union
  • carpal canal syndrome is possible complication
19
Q

Subchondral bone cysts

A
  • usually young horses, can be any bone (distal radius and UCB most common)
  • tx can be conservative or surgical and prognosis depends on accessibility of cyst
  • radial cyst prognosis good
20
Q

Carpal luxations

A
  • rare, assoc with collateral ligament damage +/- fx
  • acute lameness
  • tx closed reduction and full imb cast application
  • prognosis good if no carpal fx or cartilage damage
21
Q

Carpal Hygroma

A

Membranous, synovial fluid filled swelling over dorsal surface carpus
-ush assoc with trauma

22
Q

Carpal hygromas MAY communicate with

A
  1. RCJ
  2. MCJ
  3. Extensor carpi radialis tendon sheath
23
Q

Carpal hygromas CS

A

Non-painful, not lame

24
Q

Carpal hygromas DX

A
  1. PE
  2. U/S
  3. Contrast radiography for communications
25
Q

Carpal hygromas TX

A
  1. needle drainage
  2. corticosteroid injection (+ atropine sulfate)
  3. Systemic NSAIDS
  4. Pressure bandage
  5. Stall rest
    Chronic cases may need debridement or penrose drain
26
Q

Carpal hygroma prognosis

A

Acute-good

Chronic-poor (accumulation excessive fibrous scar tissue can limit ROM)

27
Q

Osteochondroma

A
  • Benign tumor of bone
  • often on caudodistal aspect of radius
  • don’t cause lameness unless in bad spot
  • removed surgically and dont recur

Eq SX Musc Skel Exam (20 decks)

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