Phalanges Flashcards
What are the five projections in a foot series?
Lateromedial (lateral)
Dorsopalmar horizontal beam (DP)
Dorso65*proximal-palmarodistal oblique (D65Pr-PaDiO) (Solar margin)
Dorso65*proximal-palmarodistal oblique (D65Pr-PaDiO) (Collimated DP oblique)
Palmaroproximal-palmarodistal oblique (PaPr-PaDiO) (skyline)
Purpose of the lateral view in the foot series
Two purposes
Alignment of phones relative to each other and relative to the hoof capsule
Purpose of the DP in the foot series
Three purposes
Good Balance, sole depth, joint spaces
Purpose of the Dorso65*proximal-palmarodistal oblique (D65Pr-PaDiO) (Solar margin) in the foot series
Three purposes
Evaluate solar margin and vascular channels of the distal phalanx
Evaluate Pomar and dorsal borders and articular surface of the distal interphalangeal joint or coffin joint
Purpose of the Dorso65*proximal-palmarodistal oblique (D65Pr-PaDiO) (Collimated DP oblique) in the foot series
Why is this view collimated so much?
Evaluate the navicular bone,
The collimation reduce a scatter and the shot is done at a 65 Degree angle to pull the navicular bone off the distal interphalangeal joint
Palmaroproximal-palmarodistal oblique (PaPr-PaDiO) (skyline) - purpose in the foot series
Two purposes
View of navicular bone – trabecular and cortical bone differentiation
Palmar processes of P3
How to take the lateral DP in the foot series
-four characteristics
Both feet on blocks
Center beam on coronary band
Detector perpendicular to x-ray beam
Film focal distance equals 30 to 40 cm
How to:
Dorso65*proximal-palmarodistal oblique (D65Pr-PaDiO) (Solar margin)
Three characteristics
Stand on tunnel containing detector
Center beam on coronary band
May need to decrease technique to avoid burnout of P3
How to:
Dorso65*proximal-palmarodistal oblique (D65Pr-PaDiO) (Collimated DP oblique)
4 characteristics
Stand on tunnel containing detector
Center beam on coronary band
Collimate on navicular bone
Increase mAs if needed
How to:
Palmaroproximal-palmarodistal oblique (PaPr-PaDiO) (skyline)
Four characteristics
Position Limb caudal relative to contralateral limb
Stand on tunnel containing detector
Center beam between the heel bulbs
Angle is very individual horse dependent
A view useful for evaluating Palmer processes of P3
Dorso65proximal45medial-palmarodistolateral (medial process)
Dorso65proximal45lateral-palmarodistomedial (lateral process)
What is different about the detector when radiographing the pastern
The detector is placed parallel to the angle of the pastern
A common incidental finding on the oblique projection of the pastern
What attaches here
Mild and these apathy of the dorsal medial and dorsal lateral margins of P2
The collateral sesamoidean ligaments insert here
Cysts in the DIPJ can also be seen on this view
Name of the well-defined focal concavity in the solar margin of the toe
What is a common diagnosis found at the site
Crena marginalis
Keratoma
Four other names for degenerative joint disease
DJD, osteoarthritis, osteoarthropathy, osteoarthrosis (OA)
Three characteristics of early or mild DJD
3
Increased intracapsular soft tissue (effusion and or synovial proliferation)
Osteophyte formation
Enthesophyte formation
Radiographic changes with late DJD
4
Narrowing of the joint space
Subchondral bone sclerosis
Areas of subchondral bone lysis
Ankylosis
Low ring bone
Definition
Four characteristics including comparing early versus advanced
Osteophytes tend to be more lucent then…
DJD of the DIPJ
The IPJ tolerates very little arthritic change as it is a high motion joint
Early – osteophytes along the articular margins as seen in the lateral projection
Advanced – extensive osteophyte and periosteal new bone along the distal aspect of P2 and joint space narrowing
The adjacent extensor process
High ring bone
Definition + 3 radio graphic changes
DP projection (3)
Lateral projection (2)
Oblique (2)
DJD of the PIPJ
Osteophytes/enthesoophytes, joint space narrowing, subchondral bone opacity changes
Best view to evaluate joint space narrowing, scrutinized trabecular bone adjacent to sub chondral bone plate carefully to look for sclerosis, lysis, cyst like lesions
Periosteal proliferation along the dorsal margin of the joint and difficult to appreciate narrowing on this view
Useful for lesion showing extent an exact location and joint and arrow and can also be appreciated
Fractures of the flanges are relatively…
Usually occur during…
Occasionally occur from…
Common
Athletic activity
From the horse kicking a stationary object such as a wall
Distal phalanx fracture classification
I - not articular palmar process fracture (wing)
II - articular Palmer process fracture (wing)
III - sagittal articular fracture
IV - extensor process fracture
V - comminuted articular fracture
VI - Solar margin fracture
VII - Solar margin fracture (foal)
Fracture of the middle phalanx
Most commonly seen in which horses?
Two common characteristics of these fractures
Often use what other modality when evaluating these fractures
Polo and reining horses, activities that require sliding and turns on the hindquarters
Comminution and involve articular surfaces
CT
Fractures of the proximal phalanx
Can start out as…
Sagittal groove lysis but can quickly progressed to either an incomplete or complete fracture and maybe sagittal or comminuted
Incomplete fracture of P1
Begin at…
Extend how far?
When to radiograph?
Proximal articular surface in the sagittal groove
Can extend a variable distance but do not exit
Acute phase may not see on radiograph, we radiograph 7 to 10 days later
Laminitis
Definition
Clinical signs - 6
Basic radiographic signs – 4
Inflammation of the laminate in the hoof
Severe lameness, pain localized to the foot, increase digital pulses, heat and distal limb, saw horse stance, reluctant to move
Laminar edema, thinking, rotation, radiolucent line endorse a half wall equal gas between sensitive and insensitive lamina
Laminitis
Two views
Metallic markers along blank and blank
Lateral and solar margin view
Dorsal hoof wall and coronary band
Characteristics of chronic laminitis – 3
Remodeling of the distal phalanx
Flaring, ski tip or irregularity of the dorsal border of the distal phalanx
Resorption of the distal phalanx and severely misshapen and in to have capsule
Osteomyelitis definition
When visible on radiographs?
Causes - 3
What is different about P3
Ill-defined lysis with or without periosteal proliferation
10 to 14 days following injury
Penetrating wound, Iatrogenic, extension of subsolar abscess
P3 has no medullary cavity and a modified periosteum therefore there is very little periosteal reaction and should be termed septic osteitis
Bone cyst
Two other names
Manifestation of
Typically occurs at
Subchondral bone cyst, osseous cyst like lesion
Osteochondrosis
Adjacent to any joint, typically at joint service, distal P1, proximal P2
Keratoma
Definition
Grow as blank and result in blank
Commonly seen with
Rule out…
Benign tumor that arises from the keratin containing cells of the laminar of the hoof
Grow a soft tissue masses within the half capsule and result in resorption of P3
Recurring abscesses
Prominent crena marginalis
Side bone definition
Common breeds
Common causes
Quittor definition
Ossification of the collateral cartilages of the foot
Draft and warm bloods
Poor confirmation and poor shoeing
Abscessation and necrosis of the collateral cartilage with fistulous Tract
