Joint Inflammation Flashcards
What should normal synovial fluid look like?
Yellow (straw coloured)
Clear (not turbid)
Viscous
How can you differentiate between joint inflammation and joint infection?
Look at blood parameters
* Total leukocytes
* Neutrophil %
* Total proteins
All would be very high in sepsis (infection)
How do you measure neutrophil %
Cytology under microscope
How do you measure total protein?
Refractometry
Possible causes of inflammatory joint disease
Developmental
Degenerative
Iatrogenic
Structures affected in inflammatory joint disease
Joints - synovitis
Tendon sheaths - Tenosynovitis
Bursae - Bursitis
Aetiology meaning
Cause of disease or condition
Joint inflammation aetiology
Acute
○ Fracture with intra-articular component
○ Joint injections
Joint flair
Osteoarthritis treatment
Immediate reaction (within 24-48 hours)
○ Arthroscopy/bursoscopy
Chronic
○ Bone fatigue
○ Osteoarthritis - common
How to diagnose joint inflammation
- Lameness exam
- Imaging after localising cause of pain
- Lameness exam
○ Palpation in normal physical exam
○ Localise cause of lameness
Perineural anaesthesia
Intrasynovial anaesthesia - inject LA into joint (coffin is common)
- Imaging after localising cause of pain
Radiography
Most used
First modality
Ultrasonography
Less frequently used
Useful to see remodelling at joint margins
Useful in stifle and fetlock
Scintigraphy
In poor performance cases
Identify source of bone remodelling
Image further with radiography
Cases that are more difficult to diagnose
MRI
Can visualise cartilage
Treatment of inflammatory joint disease
Depends on severity of inflammation
* Medication
* Surgical options
Medication Options
○ Anti-inflammatories
Usually corticosteroids
NSAIDs good for multiple joints - careful in competition horses
○ Biological therapies
To try and help joint get back to normal state
E.g. hyaluronic acid - helps increase viscosity of synovial fluid
Surgical options
○ Arthroscopy
○ Tenoscopy
○ Bursoscopy
○ Can lavage structures with scope
