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Equine > MSK > Flashcards

MSK Flashcards

1
Q

joints affected by bog spavin

A

distal IT and TMT joints

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2
Q

aetiology of bog spavin

A

concussion and shear forces/stress on hock joints

  • common in jumpers, western pleasure, STBs
  • conformation predisposition
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3
Q

CS of bog spavin

A
  • mild HL lameness, freq. bilateral
  • reduce performance
  • breaking on turns
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4
Q

rad signs of bone spavin

A

osteophytes + enthesiophytes + sclerosis + lysis + joint narrowing

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5
Q

bog spavin conservative tx

A
  • corrective shoeing
  • intra-articular corticosteroids +/- HA
  • systemic NSAIDs, PSGAG, HA, Epitalis
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6
Q

sx tx of bog spavin

A

arthrodesis of distal hock joints

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7
Q

sites of OCD in the tarsus

A
  1. Distal intermediate ridge of the tibia
  2. Lateral trochlear ridge of talus
  3. Medial malleolus
  4. Medial trochlear ridge of talus
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8
Q

OCD of tarsus prognosis

A

good to excellent w/ athroscopic sx

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9
Q

ddx of capped hock

A
  • gastrocnemius bursitis
  • calcaneal bursitis
  • DDFT sheath effusion
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10
Q

tx of capped hock

A
  • stop inciting cause
  • drain bursa + inject w/ corticosteroids
  • topical and systemic AI + pressure bandage
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11
Q

define thoroughpin

A

= tenosynovitis of the tarsal sheath (flexor tendon sheath of DDFT)

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12
Q

CS of thoroughpin

A
  • swelling lateral and medial to common calcaneal tendon and proximal to tuber calcis
  • most are not lame
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13
Q

tx of thoroughpin

A
  • drainage
  • intra-tendinous corticosteroids and/or HA (acts as antiinflm + reduces adhesion to tendon sheath)
  • often recurs
  • tenoscopy and lavage + ABs if infected
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14
Q

what is curb?

A

soft tissue swelling of plantar aspect of tarsus

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15
Q

CS of curb

A
  • convex appearance to plantar aspect calcaneous

- acute lameness w/ pain on palpation

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16
Q

US findings of curb

A
  • desmitis of long plantar ligament
  • tendonitis SDFT
    OR inflam/thickening of soft tissue at back of tarsus
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17
Q

tx and px of curb

A
  1. Rest
  2. Topical and systemic AIs
  3. Inject area w/ corticosteroids (US guided)
  4. Freeze firing de-innervates the c-fibres which provide pain sensation in area

Mostly good px but can recur.
Guarded for STBs - tend to chronically re-injure area

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18
Q

tarsal fracture characteristics

A
  1. most are slab fxs
  2. Can be managed conservatively or Lag screw fixation w/ CT
  3. Prognosis fair/good but will develop OA in joint if conservative tx only
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19
Q

tx of tibial stress fxs

A
  • stall rest for up to 6months
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20
Q

diagnosis of tibial stress fractures

A
  1. CS: mostly TBs in training, acute onset HL lameness w/ no other signs
  2. Blocks are inconclusive
  3. Rads - some changes if chronic
  4. Nuclear scintigraphy/bone scan = definitive diagnosis
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21
Q

CS of upward fixation of the patella

A
  1. Medial patella lig locks over medial femoral condyle –> HL locked in extension, toe drags
  2. Usu intermittent - may mimic stringhalt
  3. When they release the stifle often exaggerated flexion of the hock
  4. Typically worse in the morning - horse cold/not warmed up
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22
Q

Tx of upward fixation of the patella

A
  1. Exercise program: trot work and deep sand/hill work
  2. Oestrogen supplementation supposed to relax ligaments - wkly injection of oestradiol
  3. Counter- irritants over medial patella ligament
  4. Surgery: Medial patella desmoplasty - stab incision into medial patella ligament
    Last resort = medial patella desmotomy
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23
Q

tx and px of cranial cruciate ligament rupture

A
  • rest + AI

- guarded px

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24
Q

characteristic gait of fibrotic myopathy of the semitendinosus/semimembranosus muscles

A

foot rapidly snatch down during anterior phase

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25
Q

signalment of fibrotic myopathy

A

QH, polo, cutting, roping horses

–> tearing of flexor muscles

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26
Q

tx of acute fibrotic myopathy

A

AI, rest, physio, intra-lesional cortisone

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27
Q

causes of peroneus tertius rupture

A
  • overextension of the hock
  • direct trauma
  • avulsion fractures in foals
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28
Q

dx of peroneus tertius rupture

A

simultaneous flexion of stifle and extension of hock

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29
Q

tx of peroneus tertius rupture

A

rest, AI (local + systemic NSAIDs) + controlled exercise program after 6wks

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30
Q

treatment of pelvic fxs

A

stall rest 4-6months + re-evaluate

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31
Q

tx of proximal femoral physis fracture in foals

A

internal fixation - lag screws/ 135 dynamic hip screw

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32
Q

treatment of craniodorsal coxofemoral luxation

A
  • closed reduce under GA
  • open reduction w/ joint imbrication, screw and wire fixation or translocation of greater trochanter
  • femoral head ostectomy for <200kg
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33
Q

CS of sacroiliac subluxation

A
  • reduced performance, lameness acutely

- muscle spasm and pain on palpation

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34
Q

tx of sacroiliac subluxation

A

inject w/ cortisone or counter-irritant + rest 3m

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35
Q

what CS is diagnostic for sacroiliac subluxation?

A

“hunter’s bump”

- asymmetry of rump either side of spine

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36
Q

what is high vs. low ringbone?

A

OA of interphalangeal joints
high = proximal IP jt
low = distal IP jt

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37
Q

what conformational faults predispose to ringbone?

A
  1. Toe-in or Toe-out: sloping coronet + jt imbalance
  2. Uneven wear on distal joints + hoof wall
  3. Offset pastern: abnormal breakover
  4. Abnormal stresses on lower joints
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38
Q

high ring bone blocks to..

A

abaxial sesamoid nerve block

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39
Q

management of ring bone

A
  1. Intra-articular medications
    - corticosteroids
    - HA
    - IRAP (interleukin-1 receptor antagonist protein)
    - Arthramid
  2. Corrective shoeing: balance foot, roll the toe
  3. Pain meds: PSGAGs + NSAIDs (bute/melox)
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40
Q

sx tx of ring bone

A
  1. Pastern joint arthrodesis

fair prognosis HL> FL

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41
Q

treatment of palmar/plantar eminence fractures of P2

A
  • lag screw fixation + cast
    OR
  • arthrodesis
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42
Q

pastern subluxation causes disruption of what soft tissue structures?

A
  • SDFT and collateral ligs

- distal sesamoid ligs

43
Q

tx of pastern subluxation

A

pastern arthrodesis

44
Q

arthrodesis technique for comminuted fxs OR palmar/plantar instability of pastern

A

= double plate fixation

45
Q

indications for a transfixation cast

A
  • severely comminuted fxs

- open fxs

46
Q

treatment of pastern OCD

A
  • intra-articular medication
  • bute
  • rest
    –> will develop OA (if severe OA arthrodesis)
    OR transcondylar screw across cyst
47
Q

name the 6 different types of sesamoid fxs

A
  1. Apical
  2. Mid-body
  3. Basal
  4. Abaxial
  5. Sagittal
  6. Comminuted
48
Q

why do proximal sesamoid fxs occur?

A
  • high speed exercise + hyperextension of the fetlock

- trauma

49
Q

Diagnosis of proximal sesamoid fx by rads. What else do you need to know for prognosis?

A

need to check for concurrent SL damage via ultrasound

50
Q

which is the most common type of sesamoid fx?

A

apical sesamoid bone fx

51
Q

what causes abaxial sesamoid fractures?

A

avulsion fractures at the SL insertion point in racehorses

52
Q

why is surgery not indicated in abaxial sesamoid fxs?

A

could cause disruption of the suspensory lig

53
Q

what forces cause mid-body sesamoid fractures?

A

the bone is pulled in two directions by the suspensory and the sesamoidean ligs –> bone fails

54
Q

prognosis for basilar sesamoid fxs?

A

guarded - depends on fragment size

- loss of integrity w/ sesamoidean ligs

55
Q

tx principles of sesamoid articular fxs

A
  • remove fragments up to 1/3 size of bone
    OR
  • lag screw larger fragments + cast
56
Q

why are sesamoid fxs notoriously poor healers?

A
  • poor blood supply
  • tension
  • movement
57
Q

discuss prognosis for different types of sesamoid fxs

A

Good for apical + abaxial

Guarded for Basilar, midbody, axial + comminuted

58
Q

rad findings assoc w/ sesamoiditis

A

increased size and number of vascular channels

59
Q

two manifestations of fetlock OCD

A
  • OCD of sagittal ridge of distal MC III

- subchondral cystic lesions of distal cannon bone

60
Q

treatment of sagittal ridge lesions

A
  1. Type 1: no tx if incidental - allow horse to mature

2. Types II and III - arthroscopic removal

61
Q

tx of cystic lesions in fetlock

A
  • lag screw across cyst

- IA corticosteroids

62
Q

common site of chip fractures of the fetlock joint

A

medial dorso-proximal eminence P1

63
Q

why are HL P1 fxs more commonly spiral/larger fxs than FLs?

A

HL = greater torsion forces

64
Q

P1 short complete fx tx

A
  • stall rest if <10mm

- lag screw

65
Q

lameness assoc. w/ P1 long incomplete fxs

A

4/5 grade lameness

66
Q

tx of complete sagittal fxs of P1

A
  • internal fixation w/ lag screws
67
Q

difference between Type 1 and Type 2 proximal palmar/plantar P1 fragments

A

Type 1 = articular

Type 2 = non-articular

68
Q

cause of palmar/planter OC disease of MC/MT III

A
  • heavy/premature training of immature skeleton –> repetitive hyperextension = microfractures – cartilage damage –> bone necrosis + lysis
  • common in 3-4yo TBs in training
  • flattening of palmar condyle(s) of MC III –> impact pt during gallop
69
Q

px of POD of MC/MT III

A

guarded in severe cases

prevention and rest is key

70
Q

what’s a hygroma?

A

fluid filled swelling over the dorsal aspect of the carpus

71
Q

hygroma ddx

A

synovial hernia

72
Q

hygroma tx

A
  • needle drainage
  • inject corticosteroids 2-3x
  • pressure bandage for >14days or will come back
73
Q

common sites of carpal chip fractures

A
  • distal lateral radius (RC joint)
  • distal radiocarpal bone (MC jt)
  • proximal C3 (MC jt)
74
Q

why do carpal slab fractures most commonly occur in C3?

A

the biggest bone and susceptible to a lot of load

75
Q

lameness assoc. w/ C3 slab fx?

A

grade 4-5/5 - hobble

76
Q

C3 slab fractures are best seen with what rad view?

A

skyline of carpus

77
Q

tx and px of accessory carpal bone fx

A
  • support and stabilise carpus (splints + lots of bandage)
  • rest for 4-6m
  • fair to good prognosis
78
Q

recommended physio of in tx carpal fxs?

A

flex carpus 20-30x daily to prevent fibrosis of the joint

79
Q

prognosis of carpal fxs

A
  • rel to amount of cartilage damage and OA present
  • depends jt involved: radiocarpal > midcarpal
  • gen. good to very good
80
Q

what is third carpal bone disease?

A

starts w/ subchondral lysis as a respone to remodelling because of the load being placed on it then secondarily hardens –> sclerosis
Bone hardness prediposes to subchondral plate failure + chip/slab fxs

81
Q

tx of third capal bone disease

A
  1. rest usu 6-12wks, up to 6m
  2. athroscope: can debride to encourage healing (but rare)
  3. IA and systemic chondroprotective agents IRAP, pentosan
82
Q

px of third carpal bone disease

A

given lack of successful tx –> guarded to fair

83
Q

likely outcomes for radial fxs

A
  • euthanasia

- double plate internal fixation if <250kg

84
Q

CS for ulnar fractures

A
  • loss of tricep mm function
  • dropped elbow
  • swelling around joint
85
Q

benefits of splint stabilisation for a non-displaced fx

A
  1. restores limb support
  2. prevents contracture
  3. protects contralateral limb
86
Q

match the ulnar fx type w/ plate fixation method

A
  1. Type 1 + 2 = curved plate for apophyseal fxs

2. Types 3-6 = tension band plate

87
Q

tx of olecranon bursitis

A
  • NSAIDs
  • needle drainage + intralesional corticosteroids
  • surgical drainage OR en bloc resection

++ nullify inciting cause: soft/deep bedding or bell boots/pastern rings

88
Q

two types of humeral fxs

A
  1. Acute severe trauma –> complete fx

2. Stress fxs –> incomplete

89
Q

how does size effect humeral fx prognosis

A
  1. if <200kg: double plate fixation + IM interlocking nail + IM pins
  2. If >200kg - stall rest if incomplete or euthanasia if complete
90
Q

CS of radial nerve paralysis

A
  • unable to extend carpus or advance limb

- dropped elbow, drags limb, marked head movement

91
Q

prognosis of scapular supraglenoid tubercle avulsion fracture

A
  • if small articular component can remove
  • lag screw and tension band wire

fair prognosis, OA may develop

92
Q

prognosis of spine/body scapula fxs

A
  • poor

- high risk of implant failure w/ such thin bone

93
Q

what cause sweeny?

A
  • should trauma
  • stretch from caudal slippage of limb
  • damage to brachial plexus

–> causes suprascapular nerve damage –> atrophy of infraspinatus and supraspinatus muscles

94
Q

conservative vs. sx tx of sweeny?

A
  1. Stall rest for up to90d –> spont recovery

2. Surgery –> release nerve from entrapping fibrous tissue +/- conservative notching of scapula (fx risk)

95
Q

classification of condylar fractures

A
  1. fx configuration: complete/incomplete

2. location: displaced/non-displaced, lateral/medial

96
Q

Lateral condylar fractures tx options

A
  1. Prior to sx limb stabilisation + analgesia + IVFT
  2. Incomplete/non-displaced = lag screw fixation
  3. Complete = lag screw fixation +/- open reduction
97
Q

tx of medial condylar fractures

A
  • open reduction, lag scre fixation and neutral plate

- standing lag screw fixation via stab incisions

98
Q

radiographic diagnosis of shin soreness

A
  • periosteal new bone over dorsal cortex of MCIII
  • thickened dorsal cortex
  • radiolucent lines in dorsal cortex
  • unicortical oblique fracture(s) in dorsal cortex = saucer fx
99
Q

is high speed work okay for shin soreness?

A

yes - but shorter workouts + less often is req.

100
Q

tx of shin soreness

A

Rest 60-90d
AI
+/- Freezing firing, Percutaneous periosteal scraping, ESWT

101
Q

tx options for stress fxs

A
  1. Osteostixis

2. Unicortical screw

102
Q

what is ‘splints’?

A

bony exostosis of the 2nd or 4th MC/MT bones

103
Q

clinical significance of distal splint bone fxs?

A
  • assess suspensory lig involvement via US

- often left and reform themselves

104
Q

compare tx of proximal splint bone fxs on the medial vs. lateral splint bone

A

Medial splint bone - remove up to 1/3 prox + implants

Lateral splint bone is more forgiving –> conservative/internal fixation or complete removal

Equine (7 decks)

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