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17- SA- Musculoskeletal Disease > Investigation and management of the mature lame animal - 1 > Flashcards

Investigation and management of the mature lame animal - 1 Flashcards

1
Q

List 4 possible causes of acute lameness in mature animal

A

sprains
acute cruciate rupture
fractures both pathological and traumatic
cellulitis

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2
Q

List 3 possible causes of chronic lameness

A

osteoarthritits
humeral intracondylar fissure
nerve root tumour

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3
Q

List 3 possible causes of intermittent lameness

A

patella luxation
dislocation of the tendon of origin of the long digital extensor
superficial digital flexor instability

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4
Q

List 3 acute on chronic causes of lameness

A

cruciate rupture
pathological fracture
condylar fracture subsequent to HIF

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5
Q

List 6 things to look for on clinical exam when approaching lame animal

A

reduced/ increased range of movement
instability to joints
pain on manipulation of joints/ long bones
crepitus on manipulation of joint/ long bones
muscle atrophy
neuro deficits

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6
Q

What should be your top differential for hindlimb lameness

A

cruciate disease- until proven otherwise

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7
Q

What does the shoulder rely on for stability

A

soft tissues- muscles, tendons, ligaments

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8
Q

what injuries is the shoulder prone to

A

prone to sprains, particularly the medial glenohumeral ligament and other soft tissue injuries

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9
Q

Describe how to diagnose shoulder soft tissue conditions

A

palpation of shoulder
any pain elicited?
biceps tendon test
manipulation under GA

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10
Q

Describe the biceps tendon test

A

apply pressure to the bicipital groove whilst retracting the shoulder and extending the elbow
- is there pain?

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11
Q

what is indicative of biceps tendon rupture on biceps tendon test

A

If it is possible to extend the elbow greater on one leg compared to other? This is indicative of either biceps tendon rupture or avulsion (tearing of the tendon from its bony origin)

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12
Q

Describe the imaging techniques you can use to investigate shoulder soft tissue conditions

A

radiography- mineralisation of the infra and supraspinatus tendons.
ultrasound- good to examine biceps tendon
CT and MRI
arthroscopy- gold standard

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13
Q

Describe infraspinatus contracture

A

abducts their elbow and are unable to weight bear- not painful

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14
Q

Describe how to treat infraspinatus contracture

A

Managed by sectioning the tendon close to its insertion on the humerus

The prognosis is good

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15
Q

what dogs are generally affected by infrasponatus contracture

A

working breeds such as spinger spaniels

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16
Q

Describe the signalment of humeral intracondyalr fissure (HIF)

A

Spaniels and french bulldogs
young to middle aged

17
Q

list the clinical signs of HIF

A

Chronic forelimb lameness (can be acute)
Muscle atrophy and elbow swelling
Pain on manipulation of elbow

Minimal trauma can cause condylar fracture in young animals

18
Q

Describe conservative management of HIF

A

rest
NSIADs
but always at risk of a condylar fracture with significant morbidity

19
Q

Describe surgical management of HIF

A

Placement of large transcondylar screw - this is prone to significant number of complications

20
Q

what is the most common carpal injury

A

hyperextension- The palmar ligaments and palmar cartilage are damaged irrevocably

21
Q

how are carpal injuries generally treated

A

pancarpal arthrodesis (all the joints are fused)- as ligaments will never heal

22
Q

why is a parital arthrodesis rarely used to treat carpal injuries

A

it results in strain on adjacent joints

23
Q

Describe incomplete ossification of the radiocarpal bone

A

boxers and springers
Attempts to heal often fail as this is a similar pathology to HIF
Treat with pancarpal arthrodesis as healing of the bone very unlikely

24
Q

Describe the signs seen with Stenosing tenosynovitis of the abductor pollicus longus

A

Chronic lameness seen in large exuberant dogs

Pain on carpal flexion

Soft tissue swelling medial carpus

Boney exostoses seen over the medial aspect of the radius in chronic cases

25
Q

Describe how to treat Stenosing tenosynovitis of the abductor pollicus longus

A

steroid injection into tendon sheath
freeing or sectioning the tendon

26
Q

Describe what is seen with plantar ligament degeneration

A

proximal intertarsal subluxation with bilateral changes
Degeneration progresses to rupture and plantigrade stance

27
Q

Describe how to treat plantar ligament degeneration

A

Treat with laterally applied plate and arthrodesis of the calcaneoquartal joint.

28
Q

Which dogs generally affected by gastrocnemus tendinopathy

A

older Labrador retrievers and Dobermanns

29
Q

what does gastrocnemus tendinopathy cause

A

hyperflexion of the digits
characteristic clawing of foot due to lengthenin of gastrocneum but not the SDF tendon

30
Q

Describe how to treat gastrocnemus tendinopathy

A

resect tendon and place calcaneal tibial screw or transarticular external fixator to support the repair or a pantarsal arthrodesis

31
Q

When approaching treating open traumatic carpal/ tarsal injuries what should you treat first

A

soft tissue injury first
A temporary external fixator may help in the initial stabilisation of the joint

32
Q

Describe gracilis contracture

A

mature German shepherd dog
characteristic gait
progressive with no effective treatment

33
Q

Describe the signs seen with Iliopsoas myopathy

A

progressive hindlimb lameness
pain on extension and rotation of hip

34
Q

describe how to treat Iliopsoas myopathy

A

Rest and NSAI
OR
section the muscle at its insertion on the lesser trochanter

35
Q

what is the best way to diagnose humeral intracondylar fissure

A

CT scan- can’t always be seen on x-rays

36
Q

Describe long digital extensor avulsion

A

joint effusion with a small bone fragment
Treat by reattaching the fragment or tendonesis to the proximal tibia

37
Q

Describe long digital extensor tendon luxation

A

associated with TPLO surgery
treat by tendenosis OR securing the ligament to the tendon

38
Q

Describe avulsion of the gastrocenemius

A

low grade trauma resulting in lameness and slight plantigrade stance
Treat by reattaching the gastrocnemius by direct suture or screw

39
Q

Describe superficial flexor luxation

A

intermittent lameness
swelling over tip of calcaneus
can suture the torn retinaculum or place a screw

17- SA- Musculoskeletal Disease (20 decks)

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