soft tissue Flashcards
what are the C/S of septic synovitis?
acute onset severe lameness + effusion, ± fever, cellulitis/pain on palpation, heat
how do you dx septic synovitis?
arthrocentesis:
- TP>4g/dl
- >80% neutrophils
- TNCC>25,000 cells/ul
synoviocentesis, rads if chronic, U/S
what is the pathogenesis of septic synovitis?
joint contamination –> synovial inflammation –> increase synovial fluid + inflammatory mediators –> fibrin production –> cartilage erosion, fibrosis –> infection of subchondral bone and osteomyelitis
direct trauma into joint, invasion from infection in surrounding tissues, hematogenous infection
what are the causative agents of septic synovitis?
direct: T. pyogenes, E. coli
invasion from surrounding tissues: T. pyogenes, E. coli, Staph, Strep
Hematogenous: T. pyogenes, E. coli, Staph, Strep, M. bovis
how do you tx septic synovitis?
pain mgmt, Ab,s lavage, drainage
regional: IVRLP (IV regional limb perfusion) - 30mL sterile saline
local: intrasynovial injections
what is the prognosis of septic synovitis?
dependent on cause, # of joints, other dz
worsened by delay in tx, improved by aggressiveness of initial tx
what are the C/S of non-infectious intra-synovial disease, like DJD, OCD, trauma?
mild-mod lameness, effusion
how do you dx non-infectious intra-synovial disease (general)?
imaging, or just rest + NSAIDs
tell me the difference in surfaces affected by subchondral bone cysts and osteochondrosis
SBC: weight bearing surfaces
OCD: gliding surfaces
how do you dx OCD?
bilateral rads
femoropatellar, tarsocrural, atlanto-occipital (distribution of lesions)
how do you tx OCD?
conservative vs symptomatic tx (sx debridement, medical/pain mgmt)
what is the arrow pointing to?
subchondral bone cyst
tell me the different causes of congenital and acquired flexural limb deformities?
congenital: inherited, Mal-positioning, overcrowding in utero
acquired: secondary to prolonged period of abnormal weight bearing
congenital flexural limb deformities typically occur where?
forelimb (fetlock or carpus)
tell me about the different stages of flexural limb deformities
Stage 1: mild-mod
- calf can get up to nurse, heel doesn’t touch ground
stage 2: mod-sev
- dorsal aspect of claw more than perpendicular to ground, can manually straighten limb
severe:
- calf walks w/ dorsal aspect of fetlock/pastern/carpus on grounds unable to manually straighten limb
how do you tx stage 1 flexural limb deformities
controlled exercise, provide good footing, toe extensions
how do you tx stage 2 flexural limb deformities
NSAIDs/analgesia, well-managed splinting/casting, colostrum
half limb hind, full limb front
how do you tx severe flexural limb deformities?
rule out osseous abnormalities, if unresponsive to medical mgmt, consider sx to transect taught tendon/periarticular tissues (often unrewarding)
what is arthogryposis?
persistent joint contracture w/ abnormal bone changes (usually multiple limbs, usually rotated, often other deformities)
heriditary, nutrition, toxins, viruses in utero
what is Elso heel?
spastic paralysis
progressive neuromuscular dz (spastic contraction of both gastricnemius and SDFT) –> leads to recumbency and weight loss
Hock and stifle become increasingly extended
how do you tx Elso heel?
euth, partial tibial neurectomy, tenotomy/tenectomy
can you breed cows with Elso heel?
nope! it’s inherited
what are the C/S of cruciate ligament injury?
acute non-weight bearing lameness resolving to moderate
usually just 1 leg affected
stifle effusion
may hear click when walking
how do you dx and tx cruciate ligament injury in cattle?
dx: drawer test
tx: cull/salvage, stall rest for 6-9mo, extra-articular plication, CCL replacement
