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Lameness in Horses in Exam 2 > Joint Lameness > Flashcards

Joint Lameness Flashcards

1
Q

What is idiopathic synovitis?

A

chronic synovial effusion of a joint

unknown cause

no lameness, tenderness, head, or radiograph changes

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2
Q

What are examples of idiopathic synovitis?

A

bog spavin of tarsocrural joint

windpuffs of fetlock

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3
Q

What are the causes of bog spavin?

A

poor tarsal conformation

strain and minor trauma

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4
Q

What are the signs of bog spavin?

A

distention of tarsocrural joint

no lameness

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5
Q

How do you diagnose bog spavin?

A

clinical signs

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6
Q

How do you treat bog spavin?

A

do nothing; drainage (will probably fill back up); intraarticular injection of corticosteroids (Depo-Medrol); bandaging

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7
Q

What is bog spavin?

A

a painful swelling in a horse’s hock joint that’s caused by inflammation and fluid buildup

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8
Q

What are windpuffs?

A

fluid-filled bumps that appear on the lower legs of horses

AKA windgalls

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9
Q

What are the causes of windpuffs?

A

straight fetlocks

heavy work

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10
Q

What are the signs of windpuffs?

A

distention of palmar/plantar pouch of fetlock joint

no lameness

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11
Q

How do you diagnose windpuffs?

A

clinical signs

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12
Q

How do you treat windpuffs?

A

do nothing, pressure wraps; osmotic agents

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13
Q

What are the causes of traumatic arthritis?

A

single or repetitive episodes of trauma

can progress to osteoarthritis (OA)

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14
Q

What might traumatic arthritis include?

A

synovitis - inflammation of synovial membrane

capsulitis - inflammation of joint capsule

sprain - injury of specific ligaments associated with joint

meniscal tears - femorotibial joints

intra-articular fracture

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15
Q

What are examples of traumatic synovitis and capsulitis?

A

carpitis

osselets - fetlock joint

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16
Q

What are signs of traumatic synovitis and capsulitis?

A

effusion, heat

pain on flexion

+/- lameness

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17
Q

How do you diagnose traumatic synovitis and capsulitis?

A

rads, CT or MRI to rule-out articular changes

synovial fluid analysis to rule-out infection

arthroscopy

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18
Q

How do you treat traumatic synovitis and capsulitis?

A

conservative: rest, immobilization, hydrotherapy, liminents, DMSO, NSAIDs, shoeing changes

more aggressive: IA medications, synovectomy (surgical excision of synovial membrane)

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19
Q

What are sprains?

A

stretching or tearing of supporting ligament(s) of joint by forced movement beyond normal range

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20
Q

What are signs of sprains?

A

swelling, pain

lameness

+/- avulsion fracture: piece of bone pulled loose

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21
Q

What are luxations?

A

dislocation of joint

may be complete or parietal (subluxation) - complete - pastern, fetlock, hip, hock joints

most involve ligaments (severe pain), capsule and tendons

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22
Q

How do you treat luxations?

A

casting, surgical arthrodesis, femoral head ostectomy (FHO) for hip

will get OA

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23
Q

What are the causes of meniscal tears?

A

primary or secondary to stifle problems

shifting or shear forces between femur and tibia

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24
Q

What are the signs of meniscal tears?

A

lameness worse with exercise

effusion

positive stifle flexion

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25
How do you diagnose meniscal tears?
U/S, rads, arthroscopy
26
How do you treat meniscal tears?
stem cells arthroscopic removal of torn portion
27
What is the prognosis of meniscal tears?
50% with surgery
28
What are the causes of intra-articular fractures?
traumatic injury (fetlock or carpus) osteochondritis dissecans (OCD)
29
What is osteochondritis dissecans (OCD)?
failure of endochondral ossification cartilage/bone fragments or flaps that develop along articular surfaces of joints
30
What is the most common form of developmental orthopedic disease in horses?
osteochondritis dissecans
31
Where is osteochondritis dissecans found?
often along non-weight bearing surfaces most common - stifle, tarsus, fetlock, and shoulder
32
What are signs of osteochondritis dissecans?
joint effusion mild to moderate lameness often bilateral
33
How do you diagnose osteochondritis dissecans?
radiographs exploratory surgery arthroscopy or arthrotomy
34
How do you treat osteochondritis dissecans?
conservative - rest, joint supplements surgery - arthroscopy or arthrotomy
35
What are subchondral bone cysts?
sac-like cavities in bone beneath cartilage surface filled with fluid or soft material
36
Where are subchondral bone cysts found?
often bilateral articular or non-articular common locations - stifle (medial femoral condyle), fetlock, elbow
37
What are the causes of subchondral bone cysts?
defect of ossification (developmental) IA subchondral bone trauma
38
How do you diagnose subchondral bone cysts?
rads nuclear scintigraphy
39
How do you treat subchondral bone cysts?
conservative treatment: IA and systemic joint meds surgical treatment: debridement, injection of corticosteroids in lining, grafting of debrided cyst (bone, chondrocytes, stem cells)
40
What is the prognosis of subchondral bone cysts?
good with surgery
41
What is osteoarthritis?
AKA degenerative joint disease progressive deterioration of articular cartilage (with changes in bone and soft tissues of joint) synovitis and effusion pain and dysfunction
42
What are the primary types of OA?
acute: associated with high-motion joints (carpus and fetlock) insidious: associated with low motion joints (pastern "ringbone" and tarsus "bone spavin)
43
What are the secondary types of OA?
secondary to other identified problems intra-articular fractures luxations/sprains wounds -> septic arthritis osteochondrosis (OCD or SBC)
44
What is the pathophysiology of primary OA?
repeated concussive forces -> thickening and fibrosis of synovial membrane and joint capsule -> breakdown of articular (hyaline) cartilage -> periosteal proliferation and bone formation (osteophytes) -> decreased flexion of joint (decreased range of motion)
45
What are the signs of OA?
slight to severe lameness decreased range of motion heat, pain, swelling effusion positive flexion
46
How do you diagnose OA?
radiographs (loss of joint space, periosteal proliferation, osteophytes, enthesophytes, sclerosis) thermography nuclear scintigraphy regional and IA nerve block
47
How do you treat OA?
corrective shoeing medications: NSAIDs, IM PSGAGs, IV hyaluronic acid (HA), IA hyaluronic acid, IA corticosteroids, IA IRAP surgery: arthroscopic removal of osteophytes, arthrodesis
48
What is ringbone?
a degenerative joint disease in horses that affects the pastern (high ringbone) or coffin (low ringbone) joints
49
Where does high ringbone happen?
distal PI or proximal PII
50
Where does low ringbone happen?
distal PII or proximal PIII
51
What is bone spavin?
tarsal OA common cause of hind limb lameness involves distal intertarsal and tarsometatarsal joints (often affects dorsomedial surface first) ankylosis can occur over time --> lameness resolves
52
What are some additional treatment for bone spavin?
cunean tenectomy (part of cunean tendon is removed) surgical ankylosis (drilling) non-surgical ankylosis (chemical injection)
53
What is sacroiliac disease?
involves SI joint and/or adjacent soft tissue structures
54
What are the causes of sacroiliac disease?
single event trauma (getting cast) repetitive injury with performance
55
What are the signs of sacroiliac disease?
low grade lameness and poor performance reduced stride length in one or both hindlimbs reduced propulsion and engagement refusal to jump or go downhill bunny hop at canter swapping leads or cross cantering stiff/rigid with lack or lateral flexion in lumbosacral region behavioral changes, especially when asked to canter asymmetry of tuber sacrales gluteal muscle atrophy palpable pain over tuber sacrales
56
How do you diagnose sacroiliac disease?
pain on palpation local anesthetic nuclear scintigraphy thermography rectal examination ultrasound (assess dorsal sacral ligaments)
57
How do you treat sacroiliac disease?
rest NSAIDs muscle relaxers injection of SI joint/area (corticosteroids, antibiotics)
58
What is septic osteoarthritis?
EMERGENCY! must be diagnosed and treated ASAP to minimize and prevent OA can destroy joint quickly due to inflammatory mediators and toxins produced by bacteria inflammatory response contribute to articular degeneration
59
What are the causes of septic OA?
adult - trauma allows bacteria into joint foal - septicemia/hematogenous
60
What are the signs of septic OA?
lameness, effusion, swelling, cellulitis,
61
How do you diagnose septic OA?
synovial fluid analysis, radiography (lysis)
62
How do you treat septic OA?
sterilize joint - systemic and IA antibiotics, regional limb perfusions allow drainage - lavage with saline and antibiotics, +/- arthroscopy and arthrotomy restore normal joint environment - IA sodium hyaluronate
63
bog spavin
64
windpuffs
65
Describe the evolution of osteoarthritis
66
luxation
67
meniscal tears
68
intra-articular fracture
69
osteochondritis dissecans
70
top OCD bottom normal
71
What does OCD look like on a radiograph
72
OCD
73
OCD
74
OCD
75
Describe what a subchondral bone cyst looks like on a radiograph
76
SBC
77
OA
78
What does a joint affected by osteoarthritis look like?
79
OA
80
OA
81
Describe what ringbone looks like
82
high ringbone
83
low ringbone
84
bone spavin
85
bone spavin
86
bone spavin
87
bone spur
88
lysis

Lameness in Horses in Exam 2 (3 decks)

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