Forelimb Lameness Flashcards
What major condition of joints can result in lameness? What kind of Dx tools can we use?
OA!!
Arthroscopy
Rads
US
What is Ringbone? What are the two types?
OA of interphalangeal joints (new bone added around joints)
"Low" = DIP (coffin) "High" = PIP (pastern)
*look up pics to differentiate
How can we manage/tx Ringbone?
Both low and high can be difficult to manage medically
- Intra-articular injections (TA + HA)
- NSAIDs
- Shoeing changes
Arthrodesis
- DIPJ (low) = salvage
- PIPJ (high) = athletic use
How do we Dx MCP Jt (Fetlock): Synovitis and OA? How do we Tx?
Dx:
- Effusion of fetlock jt
- IA anesthesia
- Rads
Tx:
- Medical = IA medication
- Surgical = if severe, arthrodesis (salvage)
What traumatic fragments (of the fetlock) are common in racehorses? why?
Dorsal P1 fragments
Due to hyperextension
How do we diagnose OC fragments of the Fetlock? Tx? Prognosis?
Dx: - variable lameness - effusion of fetlock jt IA or low 4-pt nerve block - rads
Tx:
- Sx = arthroscopic removal if IA
Px:
- fair to good
What is a subchondral cyst? How do we dx? tx? Px?
Cysts in bone underneath the cartilage - caused by trauma or OC
Dx: - variable lameness - effusion of fetlock jt IA or low 4-pt nerve block - rads
Tx:
- Sx = arthroscopic removal if IA
Px:
- variable
Carpal Synovitis, Capsulitis, OA
Dx? Tx? Px?
Variable lameness
Effusion, capsular thickening, bony proliferation
Dx: Rads
Tx: IA meds; arthrodesis - severe (salvage)
Px: variable
OC fragments of the Carpus
The ____ and middle _____ joints affected
Common in ______ due to hyperextension
______ fragments»_space;»» ______ fragments
Radiocarpal
Carpal
Racehorses
Dorsal»_space;> Palmar
OC fragments of the Carpus….
Dx? Tx? Px?
mild lameness and carpal effusion
Dx:
- IA anesthesia
- Rads (multiple views)
Tx:
- arthroscopy
Px:
- good if not much cartilage damaged
Elbow OA
Dx, Tx, Subchondral cyst, Px
Decreased CRANIAL phase of stride
Dx:
- IA anesthesia
- rads
Tx:
- IA injection
Subchondral cyst
- medial radius
- traumatic or OC
- Sx = curette, screw, pack
Px: variable
Shoulder OA
Dx, Tx, Px
Decreased CRANIAL phase of stride; Secondary to OCD, traumatic
Dx:
- IA block
- Rads
- Nuclear scintigraphy
Tx:
- IA injection
- arthroscopy
Px:
- depends on extent of damage
Which phalangeal fracture is most common? How can P3 be fractured? Tx?
P2 > P1 > P3
P3 - kick wall, step hard on rock
Tx: internal or external fixation, shoeing support
Proximal sesamoid bone fx…
Dx, tx, px
Dx:
variable lameness, effusion of fetlock jt, Rads
Tx:
surgical - removal, internal fixation
Px: variable… check suspensory branches!!
MC3 condylar fractures…
Dx, Tx, Px
Dx: Rads
Tx:
surgical - lagscrew fixation + arthroscopy
Px:
good for non-displaced
guarded for displaced
What is Dorsal MC dz? who gets these most? what CS do we see?
Shin splints! (bucked shins)… “stress fracture”
Often in young racehorses (2 and 3 yo)
Lameness is variable
- painful on palpation
- thickening over dorsal aspect of MC3
Dorsal MC Dz…
Dx, Tx, Px
Dx: PE, imaging
Tx: alter training (REST!!!), extracorpeal shockwave, drill/place screw
Px: good, may take time
(KNOW)
Splint Exostosis
MC2 most common
- cosmetic
- abaxial proliferation
- typically mid or proximal sections
- variable lameness (palpable pain, acute)
(KNOW)
Splint Exostosis….
Dx, Tx, Px
Dx: rads, US (susp lig)
Tx:
- usually treat conservatively (esp acute cases_ –> NSAIDs, rest, ice, bandaging
- Sx removal/debridement (susp lig)
Px: generally good
Conditions of the Foot and Phalanges
“Low” and “High” Ringbone
Palmar soft tissue injury
Phalangeal fractures
Conditions of the Fetlock Jt
- Synovitis and/or capsulitis
- OSTEOARTHRITIS
- OC fragments - Dorsal P1 “chips”
- Osteochondrosis
- MC3 cyst
- palmar P1 fragments
Conditions of the MC region
- MC3 condylar fractures
- Dorsal MC dz
- **Splint bone exostosis
- Splint bone fractures - distal vs proximal
- Flexor tendonitis
- Suspensory ligament desmitis
Conditions of the Carpus
- Carpal synovitis, capsulitis, OA
- Osteochondral fragments - slab fractures of carpal bones
- Carpal fractures and luxations
Conditions of the Upper Limb
- *Elbow and shoulder OA
- Radius and humeral fractures
- *Olecranon fractures
- Shoulder fractures
- *Shoulder Sweeney
