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Equine (Poppy) > Foal/Juvenile Lameness > Flashcards

Foal/Juvenile Lameness Flashcards

1
Q

Distal radius growth plate closure times

A

24 months

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2
Q

Distal metacarpal growth plate closure time

A

6-9 months

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3
Q

Proximal phalanx growth plate closure time

A

6-12 months

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4
Q

Distal tibia growth plate closure time

A

17-24 months

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5
Q

Distal tibia growth plate closure time

A

9-12 months

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6
Q

Inflammation of the physis or growth complex at the end of a long bone

A

Physitis

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7
Q

Is physis active in young or old animals?

A

Young

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8
Q

When can physitis occur?

A

Until closure of growth plates

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9
Q

When does long bone growth occur?

A

Most of the long bone growth happens when the foals are resting rather than loadbearing

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10
Q

Until what age is the growth phase of the distal metacarpus?

A

4 months

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11
Q

Until what age is the growth phase of the distal radius and distal tibia?

A

18-20 months

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12
Q

Clinical signs of physitis

A

Heat
Pain on palpation
Possibly lameness

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13
Q

Joints most commonly affected by physitis

A

Carpus
Fetlock

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14
Q

Triggers of physitis

A

Sudden increase in feed intake or feed energy
Abrupt increase in exercise regimen
Direct trauma to the physis
Yearling physitis (often distal radius)

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15
Q

Diagnosis of physitis

A

Radiograph (soft tissue swelling and remodelling)

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16
Q

Treatment of physitis

A

Exercise restriction
Pain relief
Correction of underlying cause (angular limb deformity)
Sepsis?

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17
Q

Does physitis always cause lameness?

A

No, but will be lame if septic

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18
Q

Which type of Salter-Harris fracture is most frequent in foals?

A

Type II

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19
Q

Treatment options for Salter Harris fracture

A

Cast coaptation (<6 weeks)
Surgical correction (image shows transphyseal bridge)

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20
Q

Where do Salter-Harris fractures occur in foals?

A

Distal physis of MCIII/MTIII

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21
Q

Does this carpus show normal or abnormal ossification in a foal?

A

Normal

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22
Q

Bones affected by incomplete ossification in foals

A

Cuboidal bones (carpi, tarsi)

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23
Q

When does ossification occur during gestation?

A

Last 2-3 months of gestation (premature or dysmature foals should be radiographed to assess ossification)

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24
Q

Is this ossification in a foal carpi normal or abnormal?

A

Abnormal (incomplete ossification)

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25
Q

Is this ossification in a foal carpi normal or abnormal?

A

Abnormal (incomplete ossification)

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26
Q

Is this ossification in a foal tarsi normal or abnormal?

A

Abnormal (incomplete ossification)

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27
Q

Is this ossification in a foal tarsi normal or abnormal?

A

Abnormal (incomplete ossification)

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28
Q

Management for incomplete ossification in foals

A

Box rest until bones completely developed

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29
Q

What is shown in this image?

A

Angular limb deformity of carpi (valgus)

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30
Q

What is shown in this image?

A

Flexural limb deformity

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31
Q

What condition is this?

A

Windswept foal (black arrow: varus, white arrow: valgus)

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32
Q

Causes of incomplete ossification

A

Dysmature foal
Premature foal
Placentitis during gestation
Mare colic during gestation or heavy parasite burden (uterine lack of blood supply)
Abnormal uterine positioning

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33
Q

Aetiologies of angular limb deformities

A

Incomplete ossification
Peri-articular laxity
Acquired or congenital

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34
Q

Evaluation of angular limb deformities

A

Static (stand perpendicular to frontal plane of limb, not foal)
Dynamic
Manipulation (peri-articular laxity)
Radiography (orthogonal views, both limbs)

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35
Q

Can you treat angular limb deformities when peri-articular laxity is present?

A

No, monitor for loss of laxity before doing any interventions

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36
Q

Conservative treatment of angular limb deformity when there is normal ossification and peri-articular laxity

A

Box rest and controlled exercise

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37
Q

Conservative treatment of angular limb deformity when there is incomplete ossification

A

Box rest

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38
Q

When is conservative treatment of angular limb deformity acceptable?

A

Entire limb facing one way

39
Q

How should you trim/rasp the foot with carpal valgus?

A

Trim lateral hoof wall

40
Q

How should you trim/rasp the hoof foot with fetlock varus

A

Medial hoof wall

41
Q

Where should a glue on shoe extension be placed with a carpal valgus?

A

Medial extension

42
Q

Where should a glue on shoe/extension be on a foal with fetlock varus?

A

Lateral

43
Q

When is surgical treatment indicated for angular limb deformity?

A

No response to treatment
One joint facing in a different direction that the one above/below
Persistent ulna/fibula
Age

44
Q

What condition is shown in this radiograph?

A

Persistent ulna (most commonly mini horses)

45
Q

What age should surgical intervention be considered for angular limb deformity?

A

When growth has stopped/growth plates have closed

46
Q

How does this surgical intervention manage an angular limb deformity?

A

Stop growth on the lateral side

47
Q

At what age do horses suffer from juvenile osteochondral conditions

A

First 2 years of life

48
Q

What are the 5 juvenile osteochondral conditions?

A

Ligament associated OCF
Peri-articular osteocondylar fragmentation/OCF (including OCD)
Subchondral bone cyst
Osteochondral collapse
Physitis

49
Q

Clinical signs of juvenile osteochondral conditions

A

Often silent
Joint effusion?
Lameness?

50
Q

Main focus in lameness examination when investigating juvenile osteochondral conditions

A

Reaction to flexion tests

51
Q

Which joints in young horses are more commonly associated with lameness/higher levels of lameness?

A

Stifle and shoulder

52
Q

Causes of osteochondrosis

A

Multifactorial
Focal failure of endochondral ossification (epiphyseal or metaphyseal growth cartilage)
Polygenetic heritable disease

53
Q

Origin of osteochondral fragmentation in fetlock that is always caused by OCD

A

Sagittal ridge of MCIII/MTIII

54
Q

Best view to look for fragmentation due to osteochondrosis dissecans in fetlock on sagittal ridge

A

Flexed

55
Q

What is this radiograph showing?

A

Radiolucency is a fragment on sagital ridge or MCIII (always caused by OCD)

56
Q

Fragments in the fetlock with an unclear origin (may be caused by/mistaken for OCD)

A

Palmar/plantar P1 fragment (arrow, usually avulsion fragmentation by distal and oblique sesamoid ligaments)
Dorsal margin of proximal P1 (trauma)

57
Q

Types of fragmentation in fetlock joint and their common causes

A

Sagittal ridge (OCD)
Palmar/plantar P1 (avulsion, black circles)
Dorsal margin of proximal P1 (trauma, white circles)

58
Q

Age dependent top differential of subchondral lucencies on radiograph

A

<2y, OCD
>2y, trauma-induced

59
Q

Diagnosis of OCD

A

Lameness examination
4 orthogonal views (Fragments? Soft tissue swelling?)

60
Q

Challenges with diagnosis of tarsus OCD

A

Many foals have lesions at 1 month then many heal by 1 year (healing potential better in distal aspect trochlear ridge)
(Few lesions originate/resolve after age of 5 months)

61
Q

Challenges related to diagnosis of stifle OCD

A

Very dynamic process

62
Q

2 treatment options (dependent on clinical signs)

A

Leave it
Remove (usually GA, occasionally standing sedation)

63
Q

Considerations when making treatment recommendations

A

Intended purpose of horse (high speed = remove all)
Ownership (Future sale? Genomic breeding value?)
Finance, risks (GA) and prognosis

64
Q

Typical treatment recommendation for loose fragments in joint

A

Removal

65
Q

Typical treatment recommendation for osteochondrosis flattening in joint

A

Monitor and see

66
Q

When does osceochondrosis become osteochondrosis dissecans?

A

When pathology progresses from flattening to osteochondral fragmentation

67
Q

What does this radiograph show?

A

Palmar P1 defect, most likely due to cartilage so not visible on radiograph

68
Q

Aetiology that could cause palmar P1 defect (controversial)

A

Osteochondrosis
Trauma

69
Q

Aetiology of fragment of dorsoproximal P1 fragment in racehorses

A

Trauma from overextension of fetlock at high speed in racehorses
(Unclear in non racehorses)

70
Q

Most common presenting complaint in osteochondral conditions

A

Joint effusion

71
Q

What is 1 on this tarsus?

A

Distal intermediate ridge of tibia (DIRT lesion)
DMPLO view

72
Q

What is 2 on this tarsus?

A

Lateral trochlear ridge of talus
DMPLO view

73
Q

What is 3 on this tarsus?

A

Medial malleolous of the tibia (concern with OCD is intra-articular aspect)

74
Q

Top 3 sites for hock OCD

A

Distal intermediate ridge of tibia (DIRT)
Lateral trochlear ridge of talus
Medial malleolus of the tibia (intra-articular aspect)

75
Q

What is this site of osteochondrosis in the fetlock?

A

Sagittal ridge of distal metacarpal

76
Q

Main site of OCD lesions in stifle joint

A

Lateral trochlear ridge of femur (lateral trochlear ridge is shorter than the medial trochlear ridge)

77
Q

Which anatomical structure contains a cyst like structure on this radiograph?

A

Medial femoral condyle

78
Q

What does this image show? (2 year old)

A

Effusion of femoropatellar joint

79
Q

Fetlock radiograph views for OCD

A

DP
LM
+/- Flex lateral
DMPLO
DLPMO

80
Q

Where is the fragment in this DMPLO view of the fetlock?

A

Palmaro/plantaromedial

81
Q

Special view to look for palmar/plantar fragmentation in fetlock

A

Dorsal 30 proximal 70 lateral-palmarodistal medial oblique

82
Q

View to look for tarsus fragmentation

A

DP* (dorsal 15 degree lateral-plantarmedial oblique)
LM
DMPLO* (5 degrees disto-proximal)
DLPMO

83
Q

Stifle radiograph views to diagnose OCD

A

Lateromedial
Caudocranial
Caudo(60)lateral-craniomedial oblique

84
Q

Which structure for OCD diagnosis is highlighted in the stifle caudocranial view?

A

Femoral condyles

85
Q

Which structure for OCD diagnosis is highlighted in the stifle caudolateral-craniomedial view?

A

Femoral condyles
Lateral trochlear ridge

86
Q

Conservative management options for osteochondrosis

A

Box rest/small paddock
Joint injection with corticosteroids

87
Q

What condition might a horse suffer from if fragments are not removed in the tarsus and stifle?

A

Osteochondrosis

88
Q

Clinical signs of subchondral cyst-like/SCL lesions

A

Lameness (more likely than in OCD)
Joint effusion
Positive response to flexion

89
Q

Bone containing subchondral lucency in E

A

P2

90
Q

Bone containing subchondral lucency in G

A

P1

91
Q

Aetiologies of sub-chondral cyst like lesions

A

Osteochondrosis
Trauma to articular cartilage/subchondral bone

92
Q

Most common sites of subchondral cyst-like lesions (there are many)

A

Medial femoral condyle
Phalanges
Metacarpus/metatarsus
Radius
Scapula
Tibia
Carpal bones
Cervical vertebrae

93
Q

Most ‘telling’ diagnostic sign during lameness examination of subchondral cyst-like lesions

A

Improvement with joint block

94
Q

Treatment options for subchondral cystic lesions

A

Intra-lesional injection with corticosteroids (SCL which communicate with joint, arthroscopic guidance)
Mesenchymal stem cells within joint (no arthroscopy, under GA with ultrasound guidance)
Arthroscopic debridement (remove unsupported cartilage)
Transcondylar bone screw (GA, standard cortical screw or absorbable screw)
Conservative (acceptable if no lameness, needs monitoring)

Equine (Poppy) (11 decks)

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