Ortho (EQ) Flashcards

1
Q

Tendonitis of which tendon causes fetlock sinking and carpal sheath effusion?

A

SDFT

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2
Q

How do we treat SDFT tendonitis?

A

Cold hose + NSAID
Box rest for few days
Controlled exercise
Promote angiogenesis - PrP/Stem cells/US

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3
Q

What are the 2 Ddx for a swelling deep to the DDFT in the proximal metacarpus?

A

ALDDFT desmitis

DDFT desmitis

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4
Q

What is the Px for ALDDFT desmitis?

A

Guarded - likely recurrence

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5
Q

Which US features are diagnostic for suspensory desmitis?

A

Enlargement
Poor margination
Hypoechogenicity

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6
Q

What are the 2 approaches to Tx suspensory ligament desmitis?

A

Conservative: rest and shockwave therapy

Surgery: splitting, Neurectomy/fasciotomy

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7
Q

Is PAL desmitis painful on flexion or extension?

A

Flexion

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8
Q

What are the visible signs of PAL desmitis?

A

Notching of limb
DFTS effusion
+ response to DFTS analgesia

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9
Q

What are the 2 approaches to Tx PAL syndrome?

A

Conservative: Cold, NSAID, rest
Surgery: Tenoscopy and PAL desmotomy

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10
Q

Describe the aetiology of upward patellar fixation in the horse.

A

Medial pole of patellar hooked over medial trochlear ridge of femur

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11
Q

How is patellar fixation treated?

A

Exercise = build up muscle.

Can perform desmotomy as back up.

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12
Q

Following trauma, where may the SDFT luxate to?

A

Lateral Side

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13
Q

How is SDFT luxation treated?

A

Conservatively 3-6m!

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14
Q

Which muscular disease of horses presents like colic - how do you differentiate?

A

Acute Exertional Rhabdomyolysis

Urine - myoglobin
Pain over gluteals and biceps.

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15
Q

How is Acute Exertional Rhabdomyolysis treated?

A

IVFT
ACP
NSAIDs

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16
Q

How is Chronic Exertional Rhabdomyolysis managed?

A

Minimise stress, warm-up, avoid high-energy feeds

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17
Q

Which 3 breeds are predisposed to Polysaccharide Storage Myopathy?

A

Draft Horses
Warmblood
Quarter Horse

Give high fibre, low carb diet!

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18
Q

Where does the common calcaneal tendon insert?

A

Calcaneus

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19
Q

Where does the SDFT insert?

A

calcaneus

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20
Q

What occurs to the flight of the lame limb?

A

Reduced - may drag

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21
Q

In which direction do hoof cracks commonly run?

A

Proximo-distal

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22
Q

What causes hoof cracks?

A

Poor balance
Low horn quality
Trauma

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23
Q

What are transverse hoof crack associated with?

A

Coronary Band injury

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24
Q

How are hoof crack treated?

A

Debride necrotic tissue
stabilise with filler
Trim foot and unload crack (bar shoe/quarter clips best)

Treat cause
Give Local/systemic ABs

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25
Q

Describe the severity of lameness associated with Coronary Band injury

A

Moderate to severe

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26
Q

Which other structures may be involved with Coronary band injury?

A

DIP/PIP/NB/DFTS

Tendons/ligs: SDFT/DDFT/Extensors/collateral ligaments

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27
Q

How are Coronary Band injuries treated?

A
PRESERVE Coronary Band - suture it.
Stabilise hoof wall
Flush synovial structures
Antibiotics
NSAIDs
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28
Q

What is the best way to stabilise a Coronary Band injury?

A

CAST

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29
Q

What is the difference between Nail Bind and Nail Prick?

A

Bind - Nail close to sensitive structures

Prick - Nail into sensitive structures, may develop into abscess.

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30
Q

What are the signs of subsolar abscessation?

A

acute severe lameness

sensitive to hoof testers

Inc Digital Pulse and hoof temp

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31
Q

How are subsolar abscesses treated?

A
DRAINAGE
remove shoe and nail
pare foot
remove all necrotic/underrun horn
Poultice 1-2x daily
Bandage to protect food

+ NSAID/AB and Tet

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32
Q

When should a foot with a subsolar abscess be re-shod?

A

Once dry/hardened

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33
Q

A penetration in which part of the foot may involve synovial structures?

A

Middle 3rd of frog

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34
Q

What are the signs of a synovial foot penetration?

A
severe lameness
\+/- FB in foot (or wound)
Distal limb swelling
Inc digital pulse
Sensitive to hoof testers over tract
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35
Q

What is the best way to diagnose foot penetration injuries?

A

Rx +/- probe/contrast
Synoviocentesis
MRI

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36
Q

How are synovial foot penetrations treated?

A

Debride infected tissue
Flush synovial structures - bursoscopy

ABs: systemic/IVRA/Intra-synovial/PPMA beads

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37
Q

How should a synovial foot penetration be dressed following surgery?

A

Bandage
Plate to raise heel
NSAIDs

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38
Q

What is the prognosis for synovial foot penetration?

A

Fair survival to disch (56%)

Guarded return to function (36%)

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39
Q

What are 5 potential causes of chronic hoof abscessation?

A
Imm. comp (Cushing’s)
Keratoma
Laminitis 
Bone sequestrum
Collateral cartilage infection
Infective (pedal) osteitis
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40
Q

What is Quittor?

A

Infection of the collateral cartilages following wound

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41
Q

How does quittor present?

A

Swelling or discharge from coronary band

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42
Q

How is quittor treated?

A

Surgical debridement - with care to avoid DIPJ

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43
Q

What is a keratoma?

A

Benign hoof/solar horn tumour

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44
Q

How do equine keratomas present?

A

Intermittent lameness/discharge

Circular keratinisation abnormality w/disch tract

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45
Q

How can we diagnose keratomas?

A

Rx = smooth radiolucent defect in P3

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46
Q

How are keratomas treated?

A

Surgical resection (GA)

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47
Q

What is canker?

A

Hypertrophy of frog epithelium - hyperkeratotic w/fronds of unconnected horn
Fusobacterium/bacteroides involved

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48
Q

How is canker treated?

A

Early: environment, debride, metronidazole bandage + systemic ABs + astringents

Late: aggressive surgery + bandaging

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49
Q

What is white line Dz?

A

Prog crumbling hoof wall w/white line separation +/-lameness

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50
Q

What causes white line Dz?

A

Warm, wet weather

Biotin/Zn/Se deficiency

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51
Q

What are the 3 steps in treating white line Dz?

A
  1. Remove abnormal horn
  2. Support remaining horn
  3. Prevent progression
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52
Q

What is the onset/DOA of mepivicaine?

A

1-2m

45m-1h

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53
Q

What is the onset/DOA of bupivicaine?

A

4-5mm

1-2h

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54
Q

What are 3 CIs for diagnostic analgesia?

A

Suspect fracture
Cellulitis
Uncooperative horse

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55
Q

What radiographs are involved in a standard foto series?

A

ML
DP
DPr-PaDiO
PaPr-PaDiO

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56
Q

Where should the beam be aimed for an LM Rx of the foot?

A

1-2cm below CB

1/2way between dorsal hoof wall and heel

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57
Q

Where should the beam be aimed for a DP Rx of the foot?

A

Horizontal beam centred 2cm below coronary band, perpendicular to limb

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58
Q

What are the 2 versions of a DoPr-PaDiO

A

Upright (hickman block needed)

High Coronary

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59
Q

Which Rx view of the foot is known as the “skyline view”?

A

PaPr-PaDi Oblique

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60
Q

What are the signs of DIPJ Dz?

A

Uni or Bi-lateral lameness

DIPJ effusion

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61
Q

What is the best imaging technique to assess foot pain?

A

Rx

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62
Q

How is Synovitis/OA/OC frag of the DIPJ treated?

A

IA medication - hyaluranon/CS/IRAP
NSAIDs

Remove frag if present

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63
Q

How is DIPJ trauma treated?

A

Rest NSAIDs

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64
Q

How is collateral ligament desmitis diagnosed/treated?

A

MRI
Rest
Farrier (rolled toe)
Shockwave/IA meds

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65
Q

How are DIPJ OCLLs treated?

A

IA meds

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66
Q

What are the signs of pedal bone fractures?

A

Acute pain
inc digital pulse
Hoof tester +, percussion +
+/- DiPJ effusion

WITH Hx of trauma!!

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67
Q

Where are pedal bone fractures commonly located?

A

Wings of P3 - need obliques and may need advanced imaging

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68
Q

How are pedal bone #s diagnosed?

A

Partial response to local anaesthesia

Rx!

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69
Q

How are pedal bone fractures managed?

A

Immobilisation - bar shoe and hoof cast.

Extensor process: remove frag surgically
Articular: internal fixation
Non-healing wing #: PD neurectomy

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70
Q

How is pedal osteitis diagnosed?

A

Chronic foot soreness.

Rx: demineralisation and wide vasc channels

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71
Q

How is pedal osteitis treated?

A

Correct foot imbalance to reduce abnormal stresses

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72
Q

Traumatic # of which bonecauses a moderate lameness, localised by LA to the foot?

A

Navicular bone

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73
Q

What is the best Tx for navicular bone #s?

A

Conservative

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74
Q

What exacerbates navicular Dz?

A

hard surface
circle
Low heel/long toe conformation

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75
Q

What may an O notice in a horse w/navicular dz?

A

Bilateral FL lameness
Unwilling to go forward
Stumbling
Refusing Jumps

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76
Q

What histopath changes are seen in the fibrocartilage of horses with navicular dz?

A

Thin fibrocartilage w/ palmar cortex erosion and medullary lysis

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77
Q

What histopath changes are seen in the DDFT of horses with navicular dz?

A

surface fibrillation
core lesions
adhesions

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78
Q

What bony histopath changes are seen in horses with navicular dz?

A

palmar cortical bone medulla replaced w/vascular CT

Degeneration of DIP/NB articulation

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79
Q

What histopath changes are seen in the sesamoidean lig of horses with navicular dz?

A

New bone formation

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80
Q

Where may a horse with Navicular Dz be + on hoof tester?

A

Over frog (inconsistent)

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81
Q

Describe the gait of a horse with navicular Dz?

A

Toe First

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82
Q

Which nerve blocks will resolve navicular Dz?

A

PD, DIP, NB

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83
Q

What Rx abnormalities are seen in navicular dz?

A
Medullary cyst formation
Flexor Cortex erosion
Loss of corticomedullary definition
Fragmentation of distal border
Enthesophytes (L/M border)
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84
Q

What is the most important Tx for navicular Dz?

A

Farriery! Engage frog w/ground and improve heel support

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85
Q

What should be given in addition to correcting navicular Dz?

A

NSAIDs
IA hyaluranon/CS
Bisphosphonates

can perform neurectomy but complications occur!

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86
Q

How are 1e DDFT lesions diagnosed?

A

MRI - proximal to navicular bone

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87
Q

How do 1e DDFT lesions present?

A

Mild-severe acute unilateral lameness

+ve to PDNB and NB

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88
Q

How are 1e DDFT lesions treated?

A

Conservative good

Surgery if debridement indicated

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89
Q

Which perineural blocks can be used in the pastern/fetlock?

A

ASNB

L4/6NB

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90
Q

Which intra-synovial blocks can be used in the pastern/fetlock?

A

PIPJ, MCPJ

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91
Q

Which ligaments support the pastern/fetlock area?

A

sesamoidean

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92
Q

What is the medical name for “articular ringbone”?

A

Pastern OA - prog destruction articular cartilage w/ subchondral thickening and osteophyte production

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93
Q

What are the clinical signs of pastern OA?

A

Lameness

Bony thickening on dorsal aspect

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94
Q

How is pastern OA diagnosed?

A

Analgesia: Perineural or articular

Rx: standard angles, dorsal changes

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95
Q

How is pastern OA managed?

A

Rest
IA meds
Shoeing and NSAIDs

Can perform arthrodesis

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96
Q

Where is osteochondrosis most common?

A

Tarsus/Stifle

Can occur in pastern

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97
Q

How does pastern OC present on Rx?

A

osseous cysts on P1/2 and osteochrondral fragments

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98
Q

What is the Px/Tx for Pastern OC?

A

guarded Px, palliative care!

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99
Q

Traumatic injury of which 2 ligaments of the pastern may cause lameness?

A

SDFT branch

Distal Sesamoidean lig

100
Q

How can we diagnose and treat a Pastern ST injury?

A

Ultrasound

Tx: rest, Nsaids, monitor

101
Q

Which horses are predisposed to P1 fractures?

A

Racehorses - begin at sagittal groove at articular surface & extend distally

102
Q

Where do P2 fractures occur and what is their cause?

A

Palmar/Plantar eminence

Cause: acute overload

103
Q

How are pastern fractures managed?

A

Zone 1 External coaptation!

If short - conservative
If long - internal fixation
If comminuted/open - PTS

104
Q

How is pastern subluxation diagnosed/treated?

A

Signs: MARKED swelling, acute instability plus Rx!

Tx: Stabilize w/coaptation. Perform arthrodesis.

105
Q

What are the 2 causes of proximal sesamoid bone fracture?

A

acute trauma

Non-adaptive remodelling

106
Q

how do proximal sesamoid bone (PSB) fractures present?

A

Acute lameness
Swelling
Pain on palpation
Joint Effusion

107
Q

What should be used to diagnose proximal sesamoid fractures?

A

Rx
AND
US - SL injury common

108
Q

When should PSB fractures be managed conservatively?

A

Unilateral PSB # in foals

Non-articular #

109
Q

When should PSB fractures be managed surgically?

A

Fragment needing removal

Mid-body # (repair)

110
Q

When should horses with PSB fractures be PTS?

A

biaxial/comminuted

111
Q

What may be an indication of SL/annular ligament injury in young performance horses?

A

Sesamoiditis - inflm of ST at palmar fetlock and inc vascular channels in PSB

112
Q

How is sesamoiditis managed?

A

Rest, NSAIDs, Cold

If refractory - shockwave therapy

113
Q

What is the clinical significance of P1 osteochondral fragmentation?

A

Not always clinically significant - MUST block out to be the cause of lameness!

114
Q

How is osteochondral fragmentation of P1 treated?

A

Arthroscopic fragment removal

115
Q

How does Fetlock OCD present?

A

ranging from flattening of the sagittal ridge to separate fragmentation

YOUNG horses.
1+ joints involved
Effusion +/- Lameness

116
Q

Where are fetlock Osseous Cysts found?

A

Distal MCIII

117
Q

How is fetlock osteochondrosis managed?

A

surgical removal of fragments or cyst curettage

118
Q

what are the signs of fetlock OA on clinical exam?

A

Lameness exaggerated by flexion
Reduced ROM
+ IA anaesthesia

119
Q

What Rx changes are noted with fetlock OA?

A

Periarticular osteophyte formation (PrDo P1, Dorsal PSB)
Remodelling of saggital risged
Subchondral sclerosis
Joint Space reduction

120
Q

How is early fetlock OA managed?

A

Intra-articular medication e.g. hyaluranon/ corticosteroids

121
Q

How is moderate fetlock OA managed?

A

NSAIDS
IA C/S
IRAP
Polyacrylamide gel

122
Q

How is severe fetlock OA managed?

A

Arthrodesis

Euthanasia

123
Q

What causes palmar/plantar osteochondral Dz of the fetlock in young racehorses?

A

High strain = wear lines, cartilage loss.

Eventual collapse of the articular surface.

124
Q

What are the Rx signs of palmar/plantar osteochondral Dz?

A

Variable - sclerosis and contour changes

MRI/Scintigraphy better!

125
Q

How is palmar/plantar osteochondral Dz managed?

A

Change exercise routine!!

126
Q

What causes chronic proliferative synovitis?

A

Hyperextension of fetlock –> repetitive trauma to dorsal aspect

127
Q

Which part of the body is most affected by chronic proliferative synovitis?

A

Forelimb fetlock

128
Q

What are the clinical signs of chronic proliferative synovitis?

A

Lameness
Reduced ROM
Heat/pain

129
Q

How is chronic proliferative synovitis diagnosed?

A

Rx: crescent shaped bone loss distal MC3 & ST swelling

US: thickened dorsal synovial pad

130
Q

How is chronic proliferative synovitis managed?

A

IA meds

Surgical Resection

131
Q

What damage is caused buy fetlock subluxation?

A

collateral ligament disruption

avulsion fracture

132
Q

How is fetlock subluxation diagnosed?

A

Acute severe lameness
Visible luxation
Rx luxation

133
Q

How is fetlock subluxation treated?

A

Closed reduction - case (leads to OA)

Arthrodesis if unstable

134
Q

What does the Corium contain?

A

BVs and Nerves to supple lamellae

135
Q

What are the 3 main causes of laminitis?

A
  1. Inflammation
  2. Weight Bearing
  3. Endocrine
136
Q

What is the likely cause of laminitis affecting a single foot?

A

Weight bearing

137
Q

What is obel grade 1 laminitis?

A

Shifting weight
Short stride at trot
Not lame at walk

138
Q

What is obel grade 2 laminitis?

A

Short stabbing gait at walk and trot

Will lift feet

139
Q

What is obel grade 3 laminitis?

A

Move reluctantly

Resist attempts to lift feet

140
Q

What is obel grade 4 laminitis?

A

Reluctance or absolute refusal to move or lift feet

141
Q

What visible changes to the hoof may you notice in laminitis?

A
Flattening (convexity) of the sole
Depression at coronary band
Bruising or submural abscesses
Cap Horn
White Line Separation
142
Q

What causes divergent hoof rings?

A

Chronic laminitis (due to dorsal hoof wall having inhibited growth)

143
Q

What is critical to laminitis diagnosis?

A

Radiographs:
ML
DP
DPrPaDiO

144
Q

What are the 3 prognostic indicators on a laminitis radiograph?

A

D: founder distance (>15mm poor, 2-8 normal)

R: rotation (<5 good, 6-11 fair, >11 poor)

S: solar depth (prolapse poor)

145
Q

What are the 3 core principles of laminitis Tx?

A

Treat 1e Dz (endocrine, SIRS etc)

Pain Relief (NSAID +/- opioid)

Digital Support (cryotherapy, frog support and deep bed)

146
Q

Which type of shoes are helpful with chronic laminitis?

A

Reverse Shoes
Heart Bars
Imprint (glued)
EDSS

147
Q

What procedure may be used on refractory laminitis cases with rotation? (NOT FOUNDERS)

A

DDFT tenotomy

148
Q

What do you assess from an anterior view of the foot?

A

ML symmetry
Length/Angle of M/L hoof walls
coronary band relating to bearing surface

149
Q

What do you assess from a lateral view of the foot?

A

Hoof-Pastern Axis
coronary band
Dorsal wall and heel angle
Dorsal wall and heel length

150
Q

Do front or hind feet normally have a steeper angulation?

A

Hind

151
Q

Describe the footfall of a laminitic horse.

A

Heel-toe

152
Q

Which nerve blocks can be used in the metacarpus/metatarsus?

A

H4/H6NB
Subcarpal/tarsal
Lateral Palmar nerve
Deep branch of lateral plantar n.

153
Q

Describe the normal appearance of a fracture to the medial MCIII condyle

A

Spirals Proximally

154
Q

Describe the normal appearance of a fracture to the lateral MCIII condyle

A

Exit laterally above physeal scar

155
Q

What is the Px for condylar fractures of MCIII?

A

Poor - fail due to repetitive strain

156
Q

How do MCIII fractures present?

A

Moderate/severe lame
Diaphyseal displacement
Swelling/crepitus/pain
Effusion

157
Q

How are MCIII fractures diagnosed?

A

Rx!

158
Q

Describe MCIII fracture first aid.

A

zone 2 external coaptation

M/L splint if lateral condyle fracture

159
Q

Which MCIII fractures can be managed conservatively?

A

Non-displaced
Closed
Transverse
Proximal if incomplete

160
Q

Which MCIII fractures can be managed with surgery?

A
Condylar fractures (screw)
Diaphyseal fractures (plate)
161
Q

Which MCIII fractures should be PTS?

A

Displaced
Open
Comminuted

162
Q

Describe the aetiology of Dorsal Metacarpal Dz.

A

Young Racehorse.

Excessive cyclic loading - periosteitis.

2yo horse, at 3 may become stress fracture.

163
Q

How does Dorsal Metacarpal Dz present?

A

focal pain/swelling/ reduced performance/mild lameness

164
Q

How is dorsal metacarpal Dz diagnosed?

A

Rx/Scintigraphy

165
Q

What is the Tx for Dorsal Metacarpal Dz?

A

Alter Training

If refractory: Shockwave
or
Osteostixis/screw placement

166
Q

Which “splint” bone is most prone to fractures?

A

Lateral Splint (MtIV)

167
Q

What causes splint bone fractures?

A

Trauma

IF distal - fetlock hyperextension

168
Q

What is a potential complication of proximal splint bone fracture?

A

Joint Sepsis - CMC or TMT

169
Q

How are splint bone fractures diagnosed?

A

Rx

170
Q

How are splint bone fractures treated?

A

REMOVE small fragments.

Conservative: Rest, NSAID, AB, debride

Surgery: partial ostectomy (choice), internal fixation if proxmial articular.

171
Q

What is the aetiology of splint bone exostosis?

A

Trauma - periosteal bleed- bone formation

often in horses which “dish” in front

172
Q

What are the acute and chronic signs of splint bone exostosis?

A

Acute: heat, pain, swelling.

Chronic: hard bony swelling

173
Q

How does splint bone exostosis cause lameness?

A

Interferes with suspensory ligament

174
Q

What is the best management for splint bone exostosis?

A

CONSERVATIVE - rest, cold, NSAID, local C/S

Sx only if recurrent or severe

175
Q

What may cause fetlock sinking and carpal sheath effusion?

A

SDFT tendonitis

176
Q

What 2 forms of SDFT tendonitis my be diagnosed?

A

Generalised
Core lesions

USE US to detect

177
Q

How is SDFT Tendonitis treated in the first few days?

A

Cold, NSAID, dressing and box rest

178
Q

How is SDFT Tendonitis treated in the first few weeks?

A

Promote angiogenesis: PrP, tendon splitting, stem cells, US.

Minimise scar: PrP, Stem cells, US

Early exercise: promotes type III t type I collagen transition

179
Q

How is SDFT Tendonitis treated after the first few weeks/months?

A

Controlled exercise program

180
Q

What causes a swelling in the proximal palmar metacarpus deeper to SDFT?

A

ALDDFT desmitis

181
Q

Where is DDFT tendonitis typically located?

A

DFTS or digit

also in carpal/tarsal sheath

182
Q

Which condition causes a notching of the fetlock?

A

PAL constriction of DDFT with effusion

183
Q

What are the signs of PAL constriction?

A

Notching of limb
Pain on flexion
+ response to DFTS or perineural analgesia

184
Q

How is PAL constriction diagnosed?

A

US

185
Q

How is PAL constriction treated?

A

Conservative: cold, rest, NSAID, Local CS

Surgical: remove damaged portion, PAL desmotomy to relive compression

186
Q

What can be seen dorsally on US of the carpus?

A

Carpal and digital extensors and sheaths

187
Q

What can be seen on the palmar aspect of the carpus on US?

A

Carpal sheath (SDFT, DDFT, ALSDFT)

188
Q

Which breed are predisposed to CMC OA?

A

Arabs

189
Q

How is Carpal OA treated?

A

IA Meds and NSAIDs

Arthodesis in advanced cases

190
Q

How is Carpal OA diagnosed?

A

IA anaesthesia

+Rx

191
Q

How is osteochondral fragmentation of the carpus treated?

A

Arthroscopic fragment removal

192
Q

What is the colloquial term for carpal osteochondral fragmentation?

A

Chip fracture

193
Q

What are the 3 causes of osteochondral fragmentation of the carpus?

A

OA: osteophyte frag

Racing: dorsal articular margin

GA recovery: Palmar frag

194
Q

What are the 2 causes of carpal bone fracture?

A

Acute single overload

Stress maladaptation

195
Q

Which Rx views are needed for carpal bone fracture diagnosis?

A

Skyline

196
Q

How do carpal bone fractures present?

A

Acute lameness

Joint effusion and pain

197
Q

How are slab/frontal Carpal bone fractures managed?

A

Incomplete: Conservative or surgical (internal fixation via arthroscopy)

Complete: surgical only

198
Q

A horse standing with its carpus semi-flexed with a painful radiocarpal/carpal sheath effusion has what?

A

Accessory Carpal Bone fracture

199
Q

How is an Accessory Carpal Bone fracture diagnosed?

A

Rx

200
Q

Accessory Carpal Bone fracture treated?

A

Fibrosis - conservative

Can remove fragments surgically

201
Q

How do horses with carpal subluxation present?

A

severely lame with marked swelling, carpal instability and overt anatomical derangement

202
Q

How is carpal subluxation treated?

A

Full limb bandage + splints to stabilise
Partial/complete arthrodesis

PTS if fractures or carpal bone collapsed

203
Q

What is a carpal hygroma? How can you differentiate it from a tendon sheath issue?

A

Subcut fluid swelling over dorsal carpus - 2e to repeat trauma

Palpate, Rx and US

204
Q

How is a carpal hygroma treated?

A

CONSERVATIVE

wound breakdown common w/surgery

205
Q

Which nerve blocks are used to diagnose carpal canal syndrome?

A

Median/Ulnar nerve blocks or carpal sheath block

206
Q

Apart from analgesia, how may carpal canal syndrome be diagnosed?

A

Synoviocentesis
Rx
US

207
Q

What are the clinical signs of carpal canal syndrome?

A

carpal sheath effusion
Lameness - worse with flexion
Puncture wound

208
Q

What are the causes of carpal canal syndrome?

A
Idiopathic or Septic tenosynovitis
Tendinitis of SDFT/DDFT
AL-SDFT desmitis
Radial Physeal exostosis
ACB fracture
Osteochondroma of distal radius
209
Q

How are:
Radial Physeal exostosis and
Osteochondroma of distal radius
treated?

A

Removal via tenoscopy

210
Q
How are: 
Idiopathic/Septic tenosynovitis,
Tendinitis of SDFT/DDFT
and
AL-SDFT desmitis
treated?
A

Tenoscopic lavage

Debridement of damaged tendon/lig

211
Q

How is carpal canal syndrome managed

A

Treat underlying cause

+ anti-inflammatories into carpal sheath

212
Q

Where are radial fractures most commonly found?

A

Distomedial radius - due to kick

213
Q

What are the prognostic indicators for Radial fractures?

A

Swollen but weight-bearing - incomplete, can treat.

Open or non-weightbearing PTS.

214
Q

How are radial fractures treated in adults?

A

Conservatively - full limb bandage, caudal and Lateral splint.

Cross Tie horse in box.

215
Q

How are radial fractures treated in foals?

A

Internal Fixation

216
Q

Which fracture may cause a “dropped elbow” stance? Ddx?

A

Ulna Fracture

Ddx: radial nerve paralysis, triceps myopathy

217
Q

What causes ulna fractures?

A

Trauma/kick

218
Q

How are ulna fractures diagonsed?

A

Rx

219
Q

Why must the carpus be splinted in ulna fractures?

A

Stay apparatus lost

220
Q

How are ulna fractures treated in adults?

A

Tension band principle with plate fixation

Conservative causes non-union/delays

221
Q

How are ulna fractures treated in foals?

A

Plate or wire and pins.

222
Q

What are the 2 causes of fracture in the humerus/scapula?

A

Acute trauma

Stress fracture in racehorses

223
Q

Which stress conditions occur in racehorses?

A

Fracture: Humerus/Scapula/Carpal Bone/P1

Dorsal Metacarpal Dz
Fetlock palmar/plantar osteochondral Dz

224
Q

Where are the 3 common fracture sites on the equine humerus?

A

Diaphysis
Deltoid tuberosity
Humeral Tubercle

225
Q

Where are the 3 common fracture sites on the equine scapula?

A

Supraglenoid
Body
Spine

226
Q

Which fracture causes a loss of FL function?

A

COMPLETE humeral/scapula fracture

227
Q

How are Scapula/Humeral fractures Diagnosed?

A

Rx difficult

Can tru US

228
Q

How are complete humeral fractures managed?

A

PTS

229
Q

How are deltoid tuberosity/scapula spine fractures treated?

A

Conservatively

230
Q

How does elbow osteochondrosis present?

A

OCLL in proximal radius

231
Q

How is elbow osteochondrosis treated?

A

Conservative: IA meds

Surgical: Extra-articular drilling

232
Q

How does shoulder osteochondrosis present?

A

OCLL in distal scapula (+/- proximal humerus)
or
OCD of glenoid cavity

233
Q

What is the Px for elbow/shoulder osteochondrosis ?

A

Poor - 2e disease often present

234
Q

What is the presenting sign for shoulder dysplasia/subluxation?

A

Moderate/severe lameness with pain on shoulder extension/abduction

235
Q

which breeds are predisposed to shoulder dysplasia/subluxation?

A

Shetland/mini breeds

236
Q

How is shoulder dysplasia/subluxation diagnosed?

A

Rx: poor scapulohumeral alignment and 2e OA

237
Q

What must you warn the owner about reduction under GA for shoulder dysplasia/subluxation?

A

may succeed but often recurs

238
Q

Apart from reduction, how may shoulder dysplasia/subluxation be treated?

A

shoulder arthrodesis

though most cases are PTS

239
Q

What are the signs of shoulder OA?

A

Moderate to severe lameness

240
Q

How is shoulder OA diagnosed?

A

Regional analgesia

Rx

241
Q

How is shoulder OA treated?

A

Palliative - Px guarded

242
Q

What causes equine elbow OA?

A

RARE: 2e to trauma, sepsis, OCLL

243
Q

How is elbow OA diagnosed?

A

HARD - Rx best option, can perform scintigraphy

244
Q

How is Elbow OA treated?

A

IA meds/NSAIDs

Guarded Px

245
Q

Which horses are prone to elbow hygroma? (capped elbow)

A

High action or ones who lie down regularly

246
Q

How is elbow hygroma treated?

A

NSAID
ABs
Draining
Correct cause

Surgery not advised - breakdown likely