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RUSVM LASx PRACTICE QUESTIONS > Exam 2: Bone Spavin and P1 Fractures > Flashcards

Exam 2: Bone Spavin and P1 Fractures Flashcards

1
Q

The layterm for DJD of the distal intertarsal (DIT) and

tarsometatarsal (TMT) joints.

It is a common cause of hindlimb lameness in the horse

A

Bone Spavin

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2
Q

The hock joint is made up of 4 joint spaces.

Name them from proximal to distal:

A

Proximal to distal:

Tibiotarsal

PIT

DIT

TMT

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3
Q

The _______ aspect of the joint

is the most common place to see Bone Spavin

A

medial

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4
Q

Poor conformation predisposed to

______________

A

Osteoarthritis

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5
Q

What are two examples of poor conformation that

can predispose for osteoarthritis in the equine?

A

Sickle hocked

Cow hocked

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6
Q

The conformation where the back leg joints of a horse

are set with too much angle,

resulting in the hock also being excessively angled.

This can result in uneven hoof wear,

and eventually osteoarthritis

A

SICKLE-hocked

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7
Q

The conformation in an equine where the

back ‘knee’ is set inward,

resulting in a splayed look in the back legs.

This can result in the uneven wearing of hooves,

and eventually osteoarthritis

A

COW-hocked

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8
Q

Out of the 4 joints that make up the hock,

which 2 joints always communicate?

A

Tibiotarsal and PIT

(the most proximal joints)

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9
Q

What do you expect to see on rads

of an animal with bone spavin?

A

Osteophyte formation

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10
Q

What bone is the arrow pointing to?

A

Central tarsal bone

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11
Q

What grade is this bone spavin?

A

Grade 1

small osteophyte distolateral central tarsal bone

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12
Q

What bone is this arrow pointing to?

What grade is this bone spavin?

A

MT3 (3rd metatarsal bone)

Grade 2

Small osteophyte proximal dorsolateral MT3

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13
Q

What bone is this arrow pointing to?

What grade is this bone spavin?

A

Central Tarsal Bone

Grade 3

medium osteophyte distomedial central tarsal bone

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14
Q

What bone is this arrow pointing to?

What grade is this bone spavin?

A

MT3 bone

Grade 4

large osteophyte proximal dorsolateral MT3 bone

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15
Q

What are the causes of bone spavin?

A

Chronic repetitive compression

Torsion

Shear strains

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16
Q

What type of horses are bone spavins

most common in?

A

WESTERN performance horses

17
Q

This test is a specific for hock lameness,

if the horse FLEXES and ABDUCTS the leg.

Digital pressure should also be applied

to the area of the cunean bursa in search of sensitivity.

A

Church Hill Hock Test

18
Q

Describe how to perform a spavin test

A
  1. The horse is trotted to determine the degree of lameness
  2. The lame proximal hind leg is flexed for 90 seconds
  3. The horse is trotted again to see if lameness has worsened

If the horse’s lameness is worsened = Positive Spavin Test

19
Q

What is going on in this image?

A

Spavin Test

Proximal hind limb flexion

20
Q

How is bone spavin diagnosed?

A

Lameness evaluation: Church Hill Test, Spavin Test

Advanced imaging: Nuclear Scintigraphy, MRI, CT

21
Q

What type of advanced imaging would be

best to use to detect a

cortical bone disease or stress fracture?

A

Nuclear scintigraphy

22
Q

What type of advanced imaging would be

best to use to detail

soft and hard tissues in joints,

and is as good as arthroscopy for detecting

subchondral lesions?

A

MRI

23
Q

What choices for conservative medical management

are available in the treatment of bone spavin?

A

IA injections- corticosteroids, chondroprotex, auto anti-inflamms

Phenylbutazone

Exercise adaptation

Corrective shoeing

24
Q

What are your surgical options for treatment

of bone spavin (osteoarthritis)?

A

Cunean Tenectomy

Ankylosis (of TMT and DIT)

Transarticular Drilling

Laser-Facilitated Ankylosis

Ethyl Alcohol Facilitate Ankylosis

Monoiodoacetate

25
Q

What is the success rate for cunean tenectomy

in the treatment of bone spavin in horses?

A

83%

26
Q

Transarticular Drilling is a method in which to treat bone spavin.

3 divergent drill tracts at 30 degree angles are created

medially, distal to the cunean tendon.

Post-Op= Phenylbutazone

The average time required for the horse to

return to soundness after this procedure is

__________ months

A

7.5 months

27
Q

Using an Nd:YAG or Diode laser,

Laser Facilitated Ankylosis

destroys cartilage by

superheating and vaporizing __________

A

synovial fluid

28
Q

Laser Facilitated Ankylosis

promotes _______ ankylosis,

and there is significantly less fusion of

the __________ joints as compared to other methods

A

Laser Facilitated Ankylosis

promotes partial ankylosis,

and there is significantly less fusion of

the distal tarsal joints as compared to other methods

29
Q

In regards to Ethyl Alcohol Facilitated Ankylosis:

Lameness resolved in _____% of horses with bone spavin

within _______ months

A

In regards to Ethyl Alcohol Facilitated Ankylosis:

Lameness resolved in 86% of horses with bone spavin

within 3 months

30
Q

How does Ethyl Alcohol Facilitated Ankylosis work?

A

IA injection of 3 mL of 70% Ethyl Alcohol

into the affected joint

kills off nerve endings and cartilage.

Post-px, 2g of Phenylbutazone

Can return to work as soon as 3 days. (can take up to 3m)

31
Q

Which of the following is NOT and option for treatment

of bone spavin in the horse?:

Cunean Tenectomy

Transarticular Drilling

Laser facilitated ankylosis

Ethyl alcohol facilitated ankylosis

Monoiodoacetate

A

Monoiodoacetate

  • high mortality, severe pain post-op, severe complications*
  • d/t PIT joint communication*
32
Q

Where is the most common location to see

a fracture of the first phalanx (P1)?

A

In the FORELIMB

33
Q

______% of all fractures of the first phalanx (P1)

occur in the forelimb

A

75%

34
Q

How are fractures of the first phalanx (P1)

treated in horses?

A

Lag screws and a cast

35
Q

When drilling for a P1 fracture,

the most proximal screw must be within

5mm of the ___________!

A

sagittal groove!

36
Q

When drilling for a P1 fracture,

the most proximal screw must be within

5mm of the sagittal groove.

Additional lag screws are placed at

______mm intervals

A

20 mm intervals

37
Q

What salvage procedure is used in

worst case scenarios for a P1 fracture,

like comminuted fractures?

A

Fetlock Arthrodesis

38
Q

Strict stall rest in a _______ is necessary

post-op for P1 fractures,

because prognosis depends on

resultant fetlock and pastern DJD

A

10 x 12 box

39
Q

This type of P1 fracture has a poor prognosis for returning to

athleticism

A

Comminuted P1 fractures

RUSVM LASx PRACTICE QUESTIONS (24 decks)

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