Equine Fetlock and Metacarpus/Metatarsus

Question 1

What are the 5 routine radiographs for the fetlock?

Answer 1

DP
Lateral
Flexed lateral
Dorsolateral and dorsomedial obliques

Question 2

What view?

Answer 2

Lateromedial fetlock

Question 3

What view?

Answer 3

Flexed lateral fetlock

Question 4

What view? What is special about this view in the fetlock?

Answer 4

Dorsopalmar
Angle down ~20 degrees to avoid superimposition of the sesamoids over joint/proximal phalanx

Question 4

What is exposed with the flexed lateral view?

Answer 4

Dorsal surface of sagittal ridge

Question 5

What view?

Answer 5

Dorsopalmar

Question 6

What is the purpose of angling down 15-20 degrees when taking obliques/DP of the fetlock?

Answer 6

Raise sesamoids to avoid superimposition

Question 7

What view?

Answer 7

DLPMO

Question 8

What are the relevant soft tissue structures of the fetlock?

Answer 8

Question 9

What are the 3 types of synovial structures?

Answer 9

Joints
Tendon Sheaths
Bursae

Question 10

What are the 4 routine radiographs of the metacarpus/metatarsus?

Answer 10

LM
DP
DMPLO
DLPMO

Question 11

Answer 11

Early/mild osteoarthritis
red = intracapsular soft tissue swelling
green = periarticular osteophytes

Question 12

What is the difference between primary and secondary osteoarthritis?

Answer 12

Primary: result of normal wear and tear
Secondary: secondary to trauma, soft tissue injury and instability, primary infection

Question 13

Answer 13

Fetlock osteophyte

Question 14

Answer 14

Fetlock osteophyte

Question 15

Answer 15

Fetlock osteophyte

Question 16

Answer 16

Late/severe osteoarthritis

Question 17

Answer 17

Late/severe osteoarthritis

Question 18

What is highlighted with the fetlock skyline projection?

Answer 18

Dorsal surface of subchondral bone

Question 19

What view?

Answer 19

Fetlock skyline projection

Question 20

Define: Palmar Osteochondral Disease

Answer 20

Flattening of the distal palmar articular margin of MC3 with associated sclerosis

Question 21

Answer 21

Palmar osteochondral disease

Question 22

Answer 22

Progressive palmar osteochondral disease

Question 23

Answer 23

Progressive palmar osteochondral disease

Question 24

Answer 24

Condylar flattening

Question 25

Answer 25

Subchondal lucency

Question 26

What view?

Answer 26

Flexed DP Fetlock

Question 27

Answer 27

Normal sesamoids

Question 28

Answer 28

Normal sesamoids

Question 29

What is the best view to evaluate sesamoiditis?

Answer 29

Obliques

Question 30

Answer 30

Mild sesamoiditis

Question 31

Answer 31

Severe sesamoiditis

Question 32

Answer 32

Sesamoiditis

Question 33

Answer 33

Sesamoiditis

Question 34

Define: Sesamoiditis

Answer 34

Reactive changes to sesamoids *Usually non-septic and often associated with suspensory branch disease* Rad changes: enlarged vascular channels, irregular sesamoid margin, increased opacity

Question 35

Define: Axial Sesamoiditis

Answer 35

Resorptive changes associated with intersesamoidean ligament enthesopathy *Irregular lysis on the axial aspect of the sesamoid bones* Can be septic or non-septic

Question 36

Answer 36

Axial sesamoiditis

Question 37

Answer 37

Axial sesamoiditis

Question 38

What are the 3 types of proximal sesamoid fractures?

Answer 38

Apical (proximal 1/3) Mid-body Basilar (distal 1/3)

Question 39

Answer 39

Apical proximal sesamoid fracture

Question 40

Answer 40

Basilar proximal sesamoid fracture

Question 41

Answer 41

Mid-body proximal sesamoid fracture

Question 42

Answer 42

Dorsal proximal P1 fracture

Question 43

What are the 2 causes of dorsal proximal P1 fractures?

Answer 43

Overextension of the fetlock Osteochrondrosis lesions

Question 44

Answer 44

Dorsomedial proximal P1 fragment

Question 45

What is the best view to evaluate MC3/MT3 condylar fractures?

Answer 45

Flexed DO or 125DP

Question 46

Answer 46

Complete MC3/MT3 condylar fracture

Question 47

Answer 47

Incomplete MC3/MT3 condylar fracture

Question 48

Answer 48

Periostitis *"bucked shins" leading to stress fractures*

Question 49

Answer 49

Stress fracture *Acute manifestation of chronic periostitis*

Question 50

Answer 50

Stress fracture *Acute manifestation of chronic periostitis*

Question 51

What causes splint bone fractures in the proximal vs distal halves?

Answer 51

Proximal: secondary to trauma (comminuted) Distal: suspensory injury

Question 52

Answer 52

Splint bone fracture *Could have joint involvement*

Question 53

Answer 53

Splint bone fracture *Could have joint involvement*

Question 54

Answer 54

Splint bone fracture

Question 55

Answer 55

"Splints" *Aka reactive periostitis*

Question 56

What soft tissue structure would you be concerned about in this case?

Answer 56

Flexor tendon sheath

Question 57

Compare sequestrum and involucrum

Answer 57

Sequestrum: sclerotic piece of bone Involucrum: radiolucent region of bone

Question 58

Answer 58

Red = sequestrum (sclerotic piece of bone) Yellow = involucrum (radiolucent region of bone)

Question 59

Answer 59

Sequestrum

Question 60

Answer 60

Sequestrum

Question 61

Answer 61

Sequestrum

Question 62

How is OCD best evaluated?

Answer 62

LM or flexed LM *Typically seen in the sagittal ridge of MC3*

Question 63

Answer 63

Osteochondrosis

Question 64

Answer 64

Osteochondrosis

Question 65

Answer 65

Osteochondrosis

Question 66

Answer 66

Osteochondrosis

Question 67

Answer 67

Osteochondrosis

Question 68

Answer 68

Osteochondrosis Acute (sharp margins)

Question 69

Answer 69

Fragment Sesamoid/P1 separated

Question 70

Answer 70

Question 71

Answer 71

Question 72

Answer 72

Question 73

Answer 73

Chronic proliferative synovitis Yellow = smooth bone resorption

Question 74

Answer 74

Sclerosis d/t suspensory ligament enthesopathy

Question 75

Answer 75

Normal

Question 76

Answer 76

Resorption d/t suspensory ligament enthesopathy

Question 77

Answer 77

Heterogenous sclerosis d/t suspensory ligament enthesopathy

Question 78

Answer 78

Chronic proliferative synovitis