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Locomotor > DL: HL Lameness > Flashcards

DL: HL Lameness Flashcards

1
Q

High motion joint of the hock?

A 
Tarsocrural joint 
(cf. small tarsal joints more distally)
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2
Q

What is the spavin test?

A

Flexion of the limb worsens lamess with bone spavin (though not specific)

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3
Q

What is the centrodistal joint?

A

DITJ

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4
Q

Which hock joints communicate ? Clinical relevance?

A
  • 30% horses TMT and DITJ communicate
  • TCJ and PITJ
    > inflam can spread between these joint spaces
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5
Q

How is TMTJ injected?

A

From plantar aspect

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6
Q

Which hock joints most commonly afected by OA?

A

DITJ and TMTJ

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7
Q

Which tendon overlies the area where bone spavin is commonly seen?

A

Cunean tendon and bursa

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8
Q

Initial method of arthrodesis in horses?

A
  • injection of alcohol (less painful than MIA)
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9
Q

How are hock and stifle linked in the dog?

A

Similar to horse

- should not be abel to flex hock with stifle extended

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10
Q

Dxx for common calcaneal tendon in dogs?

A

Ultrasound too

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11
Q

WHich tendon sutures are best for cylindrical or flat tendons?

A
  • locking loop : flat

- 3 pulley loop : cylindical

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12
Q

2 main tx principles for tendon rupture?

A

Repair and support

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13
Q

Where should the patella lie?

A

Trochlear groove of femur

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14
Q

Where does fibula lie wrt tibia?

A

laterally

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15
Q

What happens to bone shape when muscle alignment is out

A

Sigmoid shape develops d/t forces off centre line

eg. with quadriceps contraction and fibrosis

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16
Q

Which lameness is worsened on the inside of the circle?

A

Weight bearing lameness ie. NOT something to do with the swing phase (upper limb, elbow and shoulder or stifle)

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17
Q

What is seen with bone spavin?

A

bony/hard swelling over the small tarsal joints (medial distal tarsus)

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18
Q

What may be seen on radiographs with bone spavin?

A
  • osteophytes
  • periosteal reaction
  • narrowed joint space / ankylosis
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19
Q

Which structure run over the dorsal aspect of tarsus?

A
  • peroneus tertius (branches into lateral and medial

- tibialis cranialis with medial branch (cunean tendon and bursa)

20
Q

Ddx for bone spavin?

A
  • distal tarsal bone fx

- cunean bursitis (soft tissue injury)

21
Q

Tx bone spavin

A
  • medicate joints (corticosteroids)
  • NSAIDs
  • Tiludronate IV (tildren)
  • Arthrodesis DITJ/TMTJ
    > chemical (alcohol or MIA) or surgical (drilling, plates) or laser
  • farriery
  • ?neurectomy ? cunean tenectomy
22
Q

Px for bone spavin?

A
  • fair - good for short term soundness

- guarded for long term

23
Q

What is the flexor and extensor mechanism of the hind limb? How can damage to the common calcaneal tendon be identified?

A
  • extensor = calcaneal tendon
  • flexor = digital flexors (SDFT etc)
    > if all tendons affected, will be able to flex the hock while extending the stifle, and the digits will not flex
    > if only the gastroc tendon is affected, but SDFT remains, digits will be flexed
24
Q

What types of damage may the common calcaneal tendon undergo?

A
  • avulsion
  • degenration
  • rupture/tearing
  • neoplasia
  • previous trauma to calcaneous
25
Q

Tx options for tendon rupture/

A

> repair surgically (conservative management is not effective)
- protect for >6 weeks to heal to 50% strength
calcaneotibial screw
- locks hock in extension
- risk of screw snapping
cast
- padded support dressing for 2-3 weeks after 6 weeks or orthoses
stem cells + custom orthoses?

26
Q

Which tendon suture is quicker to place and more resistnat to gap formation?

A

3 loop pulley (but 2 locking sutures better for flat tendons)

27
Q

Px for common calcaneal tendon rupture ina doberman?

A
  • good as long as sz prompt and repair protected
  • should regain normal function
    > beware rupture may be d/t degneration of the tendon so may recur in opposite limb
28
Q

Dxx for suspected back pain in the horse?

A
  • scintigraphy
  • excercise under saddle
  • diagnostic analgesia
29
Q

What radiographic view are dorsal spinous processes seen on?

A

laterolateral

30
Q

Ddx for back pain equine

A
  • impingeing spinous processes
  • intervertebral facet joint OA
  • rib fx
31
Q

Tx kissing spine

A
  • medicate intra-spinous regions
  • dorsal spinous resection (either wedge or distal tips)
  • interspinous ligament transection
32
Q

Px kissing spine after tx?

A

fair

33
Q

Presenting signs of patella luxation? Predisposing factors?

A
  • bilaterally abnormal HL gait
  • crouching posture
  • no stifle extension
  • internal tarsal rotation
  • check patella trcking
  • check tarsal alignment
    > shallow trochlear groove of femur
    > abnormal patella position (quads displaced to the same side)
34
Q

Outline patella grading system

A

1 - can be pushed out but immediately reduces
2 - spontaneously luxtes but remain in trochlear groove predominantly
3 - patella resides out of trochlear groove predominantly but can still be reduced with manual pressure
4 - patella resides out of trochlear groove and cannot be reduced

35
Q

Tx patella luxation?

A

> surgical correction
- tibial tuberosity transposition (lateral)
- trochlear sulcoplasty (wedge or block)
- lateral soft tissue imbrication
- medial soft tissue release
- distal femoral osteotomy
NOT conservative

36
Q

Px patella luxation after tx>

A
  • good
  • if surgery successful and patella remains in trochlear groove
  • but will develop DJD in the stifle so may suffer low grade lameness/stiffness
  • risks: patellar relux, implant failure or bone fx
37
Q

How do equine patellas differ to small animal?

A
  • laterally luxating patellas normal in shetlands
  • upward fixation of the patella common
  • usually young animals d/t muscle weakeness
    > best tx initially = excercise
  • if persistent = medial patellar ligament desmotomy (danger of apical patella fragmenetation)
38
Q

Which stifle joints communicate? LOOK UP

A
  • Anatomically, FPJ and MFTJ most, FPJ and LFTJ a little bit
  • Functionally slightly less
  • degenerative??
39
Q

How would a medial meniscal tear appear on ultrasound?

A

Disruption of fibres between tibia and medial femoral condyle (ultrasound of medial aspect of the stifle)

40
Q

How can menisci cause lameness in the horse?

A
  • meniscal tears
  • medial more frequently affected than lateral
  • lameness can be mod-severe
  • evaluation by palpation (FT and FP joint distnesion, palpate displacement directly)
    > imaging
  • rads (new bone on MICET, best seen flexed lat-med)
  • ultrasound (tears usually horizontal, assess position of meniscus - prolapse important for stability and Px)
  • arthroscopy
41
Q

Tx mensical tears in horses?

A
  • arthroscopic debridement

+- Stem cells?

42
Q

Px meniscal tears horses?

A
  • Grade1 : 63%
  • Grade2: 56%
  • Grade3: 6%
    > if visable ultrasonographically Px worse
43
Q

What clinical and radiographic signs may be seen concurrentlly with CrCL dz? Ddx for these signs?

A
  • muscle atrophy proximally
    -joint effusion (cranial displacemet of infraptellar fat pad, caudal displacmeent of subgastrocnemial fascial plane)
  • periarticular osteophytosis (distal patella, prox trochlear ridge, fabellae, tibial plateua, remodelled popliteal sesamoids, stifle WNLs)
    > Collateral damage -> instability
    > OCD of femoral condyle
    > patella luxation
    > septic arthritis
    > neoplasia
44
Q

Tx CrCL Dz?

A 
> surgery
- extracapsular
- TPLO/TTA
- intracapsualr (Not advised naymore) 
> conservative
- dogs under 15kg and cats better 
- takes a loooong time
45
Q

Px CrCL Dz?

A
  • fair (limb function should improve considerably)
  • but DJD progressive and permenant
  • dogs never recover 100% limb function despite doing well
  • some stiffness/lamenss

Locomotor (29 decks)

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