LA Ortho - Hindlimb Lameness Flashcards by Mckenna Maloney

Tarsus
# of compartments

Numerous articulations
4 synovial compartments
Numerous ligaments

How well did you know this?

Not at all

Perfectly

Radio views for the tarsus

Lateromedial
Dorsopalmar
DLPMO
DMPLLO

How well did you know this?

Not at all

Perfectly

Causes for tarsocrural joint effusions

Idiopathic
Synovitis/capsulitis
Conformation
Osteochondrosis
Fracture
Desmitis
Septic arthritis
“Bog spavin”

How well did you know this?

Not at all

Perfectly

Calcaneal bursitis

Aka capped hock
Swelling of sub q or sub tendon bursa

How well did you know this?

Not at all

Perfectly

Synovitis of tarsal sheath

Idiopathic effusion of tarsal sheath
Swelling cranial to point of hock
Typically asymptomatic
Requires no treatment

How well did you know this?

Not at all

Perfectly

Thoroughpin

Synovitis of tarsal sheath

How well did you know this?

Not at all

Perfectly

Treatment for thoroughpin

Cryotherapy
Rest
IA meds
HA, IRAP serum, Cortsteroids
Arthroscopic surgery
Antimicrobials if septic

How well did you know this?

Not at all

Perfectly

OA in Tarsometatarsal & distal intertarsal joints

Tibiotarsal & proximal intertarsal NOT involved
Usually due to wear & tear
Repeated compression/rotation
Poor conformation

How well did you know this?

Not at all

Perfectly

Therapeutic goal for TMT and distal IT joints

Pain relief/ recovery of soundness
Not cartilage preservation - want to remove cartilage
Can get away with the removal of cartilage bc
- low motion joints
- slow disease progression
- joint fusion is the goal

How well did you know this?

Not at all

Perfectly

Medical treatment for TMT & distal IT joints

Want the joint to get worse which will help the joint get better - keep them comfortable to keep them working
Corrective shoes
NSAIDS, Cortsteroids
HA
PSGAG
Nutraceuticals

How well did you know this?

Not at all

Perfectly

Arthrodesis
Surgical/chemical

Surgical - drill across joint space
Chemical - 70% ethyl alcohol = protein destruction

How well did you know this?

Not at all

Perfectly

Clinical presentation for ligament injury

Synovial effusion
Soft tissue swelling

How well did you know this?

Not at all

Perfectly

Curb

Injury to the plantar ligament

How well did you know this?

Not at all

Perfectly

Tarsal luxation

Due to trauma
Acute severe lameness, ST swelling, instability
Radiographs @ stressed views

How well did you know this?

Not at all

Perfectly

Treating a tarsal luxation

Full limb cast (foot to stifle)
Internal fixation if fractures

How well did you know this?

Not at all

Perfectly

Prognosis for tarsal luxation

Pasture joint - fair to poor
Depends on degree of lig damage

How well did you know this?

Not at all

Perfectly

Stifle
# of compartments
Ligs involved

3 synovial compartments
- femoropatellar
- lateral & medial femorotibial
Collateral ligs
Patellar ligs
Menisci
Cruciate ligs

Causes for stifle effusion

Idiopathic
Synovitis /capsulitis
Osteochondrosis
Fracture
Soft tissue injury
Septic arthritis

OA development in stifle

Chronic use - high motion joint
Trauma
Meniscal tears
Cruciate tear
Joint instability
Untreated OCD

Prognosis for OA in stifle

Depends on cartilage damage, bone remodeling, joints involved, ST damage, progression

OCD in general

Most common clinical sign - synovial effusion
Degree of lameness (often in young horses)
Flexion test - mild positive
Radiograph bilaterally

common sites for ODC in tarsus

Distal intermediate ridge of tibia
Lateral trochlear ridge of talus
Medial trochlear ridge of talus
Medial + lateral maleoli of tibia

Prognosis of OCD

Depends of severity of cartilage damage & bone remodeling
Age @ treatment/duration - better if treated arthroscopically at young age

Prognosis % of ODC

77% return to racing when fragments are surgically removed
Resolution of synovial effusion 74-83% resolve

Upward patellar fixation

Young developing horses, minis, ponies, Donkeys Intermittent - Mild catching of patella during flexing, self correcting Permanent - severe lameness, unable to manually correct

Diagnosing for UPF

Clinical signs and signalment is very obvious

Pathophys of UPF

Problem w releasing the passive stay apparatus Muscles could be developing too slow for how quickly the skeleton is growing

Role of quadriceps femoris in UPF

Quadriceps fem is under conditioned & unable to lift patella up/off the medial trochlear ridge of femur to release stay apparatus

Intermittent UPF treatment

Modify training to target quadriceps femoris Inject counter irritants into medial patellar lig - creating a controlled amt of inflammation, promotes scar tissue formation

Surgical approach for UPF

Desmoplasty Split the medial pat lig Stimulate growth, lay down new collagen

Prognosis for UPF

Good but depends on Response to conserv therapy Response to MPL splitting MPL desmotomy - last resort, will develop OA

Stringhalt forms

Classic (idiopathic) - often unilateral Australian form - due to dandelion ingestion - bilateral

Characteristic gaits w stringhalt

Observe at walk or trot Involuntary /exaggerated flexion of one or both hind limbs Limb jerked upwards in cranial phase of stride

Diagnosing stringhalt

Observe exaggeration in gait Presence of toxic dandelions and evidence of lack of forage

Treatment & prognosis of stringhalt

Prevent ingestion of dandelions (50-78% spontaneously recover) Lateral digital extensor myotenectomy Cut muscle proximally & tendon distally (leaving the long digital extensor)

Shivers - clin signs

Gradually progressive, chronic neuromuscular disease Results in gait abnormalities when backing or working on hind feet, trembling tail when held erect, trembling of thigh muscles (shivers), flexed & trembling hind

Diagnosing shivers

Differentiate from string halt Commonly found in draft horses No treatment and prognosis is variable

Fibrotic myopathy - diagnosis

Traumatic etiology - sliding stops, sharp turns on hind Palpable fibrosis of Semitendinosus (membranous) Abrupt cessation of cranial phase of stride of effected limb Foot jerked caudally just before it hits the ground

Treatment and prognosis for fibrotic myopathy

Semitendinosus tenotomy Cut tendon of insertion of medial side of leg, displaces loading more freely Few surgical complications, improvement is to a variable extent

Ruptured gastrocnemius muscle

Depends on partial or complete - inability to fix stay apparatus Treat w stall rest & stabilization Foals - favorable prognosis Adults - poor for complete ruptures

Ruptured peroneus tertius muscle

Diagnosis - abilit to extend tarsus while stifle is flexed Stall rest - 6 weeks, controlled exercise 3 months 78% return to previous exercise, 21% euthanized