MSK 6 Flashcards
who is more likely to get synovial infection - foals or adults
foals
what do you look for on joint tap
number of neutrophils
appearance
TP
SAA
causes of synovial sepsis in adult
trauma
iatrogenic
extension (cellulitis)
signs of synovial sepsis in adults
wound
lameness
heat/swelling
*NO pyrexia
what will you see on xray for synovial sepsis
gas in joint
how to do synoviocentesis
- asceptic, remote to wound
- sedate + local
- EDTA for cytology
what would indicate synovial sepsis:
color
clot formation
TP
Nucleated Cells
% Neutrophils
color - yellow, serosanguinous
clot formation - increased
TP - 30-60
Nucleated Cells - 20+
% Neutrophils - 90
iatrogenic bacteria seen in joint
staph aureus
tx for synovial sepsis
lavage, remove necrotic bone
AB
why are NSAIDs questionable for synovial sepsis
may mask lameness
*can try using SAA as marker instead
needle lavage c.f. arthroscopy
needle is cheap/easy, good for acute
but cannot remove pannus/FB, cannot visualize
should you do a C&S for synovial sepsis
yes
which AB to start w for systemic and IA for synovial sepsis
systemic: penicillin, gentamicin
IA: amikacin
other options for local AB besides IA
Regional perfusion (use wide tourniquette)
Impregnated sponges/beads
when use IVRP over IA AB
bone or wound infection
foals
what is different about foals for synovail sepsis
usually indicate medicaly condition, haematogenous spread.
any foal w infection is at risk
more likely to have osseous involvement
types of septic arthritis in foals
S type = synovial
E type = epiphysis
P type = physis (growth retardation)
signs of synovial sepsis in foals
lameness
effusion
pyrexia (unlike adult)
multi-systemic dx
tx for synovial sepsis in foals
prolonged AB (C&S)
needle lavage
NSAIDs
ddx for loss of P3 outline
septic pedal osteitis
keratoma
causes of pedal osteitis in foals? adults?
foals - haematogenous, trauma
adults - chronic abscess, WLD, trauma
wahts needed for sequestrum formation
loss of blood supply to bone
bacterial contamination
