DL/DS Swollen Joints Flashcards
Pattern spotting :
3mo foal, v lame LF, multiple swollen joints - hot, effusive and painful, 3w prior foal tx with short course Abx for cough/fever/^RR
- suspect septic arthritits (pyrexic complaint previously, acute onset)
> arthrocentesis, joint fluid analysis, C+S - leukocyte count >30,000 cells/uL >90% neutrophils and elevated TP >2.5g/dl
- culture results may be negative (use blood culture medium or synovial biopsy to ^ accuracy)
> radiograpohy repeated weekly - normal initially
- lysis few days after onset
- presence of osteomyelittis afects Px and Tx
Logical approach:
3mo foal, v lame LF, multiple swollen joints - hot, effusive and painful, 3w prior foal tx with short course Abx for cough/fever/^RR
> young animal systemic problem - 3mo, multiple swollen joints > acute problem serious nature - hot, effusive, painful joints, very lame > possible infectious hx - resp infection >> PLAN - biochem/haem to r/o systemic problem - arthrocentesis, joint fluid abnalysis, C+S, radiography
Tx septic arthritis foals?
> emergency!
- tx BS Abx while waiting for C+S(cephalosporin or panicillin/aminoglycoside combo eg. pen and gent) IV or IA
- joint lavage
- resample joint fluid q48hrs
management
- minimising joint movement helps reduce damage but passive movment may minimise fibrin adhesion
- box rest and supportive bandaging, physiotherapy
Px septic arthritits foals?
- Prompt recogniition, aggressive Tx and local ABx = improved px
- multiple istes of involvement = ^ risk of poor future atheltic performance
> define and refine:
- sudden onset lameness 10 landraceX gilts large commercial unit, msot lame single HL, bilateral sweeling tarsus, one animal recumbent.
- all animals from group brought in 9d ago @110kg breeding replacemenet
- pigs housed in a yard system on solid floors
- group of pigs, likely infectiou s
- replacement gilts underweight, unlikely to be DJD
- pigs show different clinical signs: disease is progressive
- solid floor: risk of trauma? multiple pigs affected concurrently though.
> DXx
- sudden onset lameness 10 landraceX gilts large commercial unit, msot lame single HL, bilateral sweeling tarsus, one animal recumbent.
- all animals from group brought in 9d ago @110kg breeding replacemenet
- pigs housed in a yard system on solid floors
- isolate new pigs and incontact
- synovial fluid sample and cultre
- temperature if raised suspect infection
- cull most severely infected (recumbent) PM
- rads and ultrasound not possible $$$$$
- Ab assay on bloods for common diseases
Ddx:
- sudden onset lameness 10 landraceX gilts large commercial unit, msot lame single HL, bilateral sweeling tarsus, one animal recumbent.
- all animals from group brought in 9d ago @110kg breeding replacemenet
- pigs housed in a yard system on solid floors
- mycoplasma hyosynoviae infection
- DJD
- Erysipelas infection
- Glassers disease
- Trauma
> See ppt for good table
Tx mycoplasma hyosynoviae?
- lincamycin/tiamulin
- prevention: in feed medication, lower stress, resp spread control
> Dxx:
- 2yo TB racehorse
- acute onset, mod LF lame after gallop, heat and effusion @ carpus, + response to felxion of carpus
- rads (both limbs, bilateral dz common)
- joint block
- arthroscopy
What would be seen on rads concurretnly with a carpal chip fx?
- joint effusion
- osteophyte formation poss
Pathogenesis of carpal chip fx?
- cumulative microdamage d/t repetitive loading
- loss of smooth articular surface, OCD fragments -> synovitis, effusion and pain
- chronic release of MMPs, enzymes and catalytic enzymes may -> DJD and OA
- OA and fibrosis of joint capsulle restrict ROM and perfomrance
Tx carpal chip fx?
- standing arthroscopic sx to remove chip and debride joint
- +- lavage
- skin sutures
- NSAIDS
pX CARPAL CHIP FX?
- most common fx in racehorses (2nd most common intercarpal joints)
- px excellent
- px worsens with chronicity and loss of cartilage
Most common site of carpal chip fx?
- craniodistal intermediate carpal bone
Dxx:
- 5yo DSH cat
- 4wk hx lethargy, not going outside esp morning
- acute lameness LH, swollen hot effusive left tarsus and swollen R tarsus and carpus
- radiographs
