MSK- Sparks Lecture

Question 1

this 14 months old cow had stifle effusion and had a mild lameness. Dx?

Answer 1

probably OCD

Question 2

if a cow was acute onset of severe lameness + effusion, +/- a fever, some cellulitis or pain on palpation, and the lesion is hot, how should you proceed?

Answer 2

likely an infectious thing going on

start with synoviocentesis

if chronic, do rads

Question 3

if a cow has mild to moderate lameness with some effusion with no other signs, how should you proceed?

Answer 3

suspect non infectious disease, could consider imaging like rads and rest + NSAIDs

Question 4

the end result of any joint damage is

Answer 4

degenerative joint disease

Question 5

characteristics of osteochondrosis

Answer 5

a multifactorial disease

usually presents between 1-2 yo

usually bilateral–>take rads of both sides

usually femoropatellar, tarsocural, sometimes atlanto-occipital

Question 6

how to treat oesteochondrosis?

Answer 6

can do symptomatic treatment, or can do arthroscopy or arthrotomy

Question 7

Answer 7

this is urgent!

possibly a septic wound

do a joint tap

Question 8

how to workup and diagnose infectious synovitis?

Answer 8

arthrocentesis: will have a TP over 4, over 80% neutrophils, total nuclear cell count is >25,000

rads: bony changes, possibly osteomyelitis

ultrasound: fibrin in the joint–>chronic inflammation

Question 9

how does joint contamination progress to osteomyelitis?

Answer 9

contamination, synovial inflammation, increased fluid and cells, fibrin production, cartilage erosion and fibrosis, infection of the subchondral bone and osteomyelitis

Question 10

what are the 3 ways infectious joint disease can happen? what are the bacterial pathogens usually associated with each?

Answer 10

direct trauma (E coli, T pyogenes), invasion from surrounding tissues (can also be staph and strep), hematogenous infection (all the above but mycoplasma)

Question 11

3 main treatments for synovial sepsis? what other treatments can be given?

Answer 11

reduce bacterial load, control inflammation, resolve pain

others: NSAIDs, lavage, drainage

Question 12

what veins shoukd ya poke when doing the IV regional limb perfusion?

Answer 12

common digital vein or medial and lateral digital vein

Question 13

when is local treatment of synovial sepsis appropriate?

Answer 13

if the problem is localized to the synovial space and it’s not open and/or draining

Question 14

prognosis of septic synovitis?

Answer 14

depends!

worse if there’s a delay in treatment

improved by aggressiveness of initial treatment

Question 15

how does mycoplasma usually present?

Answer 15

usually multiple septic joints with concurrent disease, can affects cows of any age, can be concurrent with mastitis or pneumonia, usually affecting large joints

Question 16

acquired flexural limb deformities are usually due to what

Answer 16

prolonged period of abnormal weight bearing (animal not bearing weight and then the tendons shrink and it becomes permmanent)

Question 17

describe what stage 1 mild/moderate flexural deformity looks like and how you treat it?

Answer 17

• the calf can get up and nurse, but the heel does not contact the ground
• treatment: give em booties, can use splints, controlled exercise

Question 18

describe what stage 2 moderate to severe flexural deformity looks like and how you treat it?

Answer 18

• dorsal aspect of the claw is angled more than perpendicular to the ground but you can manually straighten the limb
• treartment: NSAIDs and analgesia, casting and splinting, make sure they get colostrum

Question 19

describe what stage 3 or severe flexural deformity looks like and how you treat it?

Answer 19

calf walks with the dorsal aspect of the fetlock or pastern or carpus on the ground and you cant manually straighten the limb

treatment: rule out osseous abnormalities, can do surgery but it is often unrewarding

Question 20

what is arthrogryposis?

Answer 20

joint contracture WITH abnormal bone changes, usually affecting multiple limbs and they are usually rotated. there is usually a cause so GO LOOKING

Question 21

what is this

Answer 21

elso heel/spastic paresis

a progressive neuromuscular disease that is inherited–>spastic contraction of gastroc and SDFT–>eventually recumbency and weight loss

misfiring and jerking of the hind limbs

Question 22

treatment of elso heel?

Answer 22

euthanasia or referral surgery

Question 23

WOT

Answer 23

ruptured proneus tertius, fair prognosis, not a big deal

Question 24

WOT

Answer 24

ruptured gastroc or SFDT, bad prognosis

Question 25

CS of CCL rupture in a cow and how you can treat

Answer 25

acute NWB lameness resolving to moderate, stifle effusion, only one leg affected, may hear click when walking

treatment: can either do stall rest or can do surgical treatment

Question 26

treatment options for coxofemoral luxation

Answer 26

closed reduction: best if the luxation is less than 12 hours old

open reduction: easier, can stabilize the joint to prevent luxation happening again, better if it’s chronic

Question 27

poor prognosis for ____ type of coxofemoral joint luxation

Answer 27

cranioventral

Question 28

dorsal luxation of the patella is common in _____. CS?

Answer 28

beef cows, working animals, animals in late gestation of rapid growth

CS: limb locks in extension and they will drag their hind leg behind themselves

Question 29

lateral/medical patellar luxation happens why?CS? which is more common

Answer 29

cannot extend the stifle and bear weight

usually congenital, trauma, or femoral nerve damage (like with dystocia)

lateral way more common