soft tissue

Question 1

what are the C/S of septic synovitis?

Answer 1

acute onset severe lameness + effusion, ± fever, cellulitis/pain on palpation, heat

Question 2

how do you dx septic synovitis?

Answer 2

arthrocentesis:
- TP>4g/dl
- >80% neutrophils
- TNCC>25,000 cells/ul

synoviocentesis, rads if chronic, U/S

Question 3

what is the pathogenesis of septic synovitis?

Answer 3

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

Question 4

what are the causative agents of septic synovitis?

Answer 4

direct: T. pyogenes, E. coli
invasion from surrounding tissues: T. pyogenes, E. coli, Staph, Strep
Hematogenous: T. pyogenes, E. coli, Staph, Strep, M. bovis

Question 5

how do you tx septic synovitis?

Answer 5

pain mgmt, Ab,s lavage, drainage

regional: IVRLP (IV regional limb perfusion) - 30mL sterile saline

local: intrasynovial injections

Question 6

what is the prognosis of septic synovitis?

Answer 6

dependent on cause, # of joints, other dz

worsened by delay in tx, improved by aggressiveness of initial tx

Question 7

what are the C/S of non-infectious intra-synovial disease, like DJD, OCD, trauma?

Answer 7

mild-mod lameness, effusion

Question 8

how do you dx non-infectious intra-synovial disease (general)?

Answer 8

imaging, or just rest + NSAIDs

Question 9

tell me the difference in surfaces affected by subchondral bone cysts and osteochondrosis

Answer 9

SBC: weight bearing surfaces
OCD: gliding surfaces

Question 10

how do you dx OCD?

Answer 10

bilateral rads
femoropatellar, tarsocrural, atlanto-occipital (distribution of lesions)

Question 11

how do you tx OCD?

Answer 11

conservative vs symptomatic tx (sx debridement, medical/pain mgmt)

Question 12

what is the arrow pointing to?

Answer 12

subchondral bone cyst

Question 13

tell me the different causes of congenital and acquired flexural limb deformities?

Answer 13

congenital: inherited, Mal-positioning, overcrowding in utero

acquired: secondary to prolonged period of abnormal weight bearing

Question 14

congenital flexural limb deformities typically occur where?

Answer 14

forelimb (fetlock or carpus)

Question 15

tell me about the different stages of flexural limb deformities

Answer 15

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

Question 16

how do you tx stage 1 flexural limb deformities

Answer 16

controlled exercise, provide good footing, toe extensions

Question 17

how do you tx stage 2 flexural limb deformities

Answer 17

NSAIDs/analgesia, well-managed splinting/casting, colostrum

half limb hind, full limb front

Question 18

how do you tx severe flexural limb deformities?

Answer 18

rule out osseous abnormalities, if unresponsive to medical mgmt, consider sx to transect taught tendon/periarticular tissues (often unrewarding)

Question 19

what is arthogryposis?

Answer 19

persistent joint contracture w/ abnormal bone changes (usually multiple limbs, usually rotated, often other deformities)

heriditary, nutrition, toxins, viruses in utero

Question 20

what is Elso heel?

Answer 20

spastic paralysis

progressive neuromuscular dz (spastic contraction of both gastricnemius and SDFT) –> leads to recumbency and weight loss

Hock and stifle become increasingly extended

Question 21

how do you tx Elso heel?

Answer 21

euth, partial tibial neurectomy, tenotomy/tenectomy

Question 22

can you breed cows with Elso heel?

Answer 22

nope! it’s inherited

Question 23

what are the C/S of cruciate ligament injury?

Answer 23

acute non-weight bearing lameness resolving to moderate

usually just 1 leg affected

stifle effusion

may hear click when walking

Question 24

how do you dx and tx cruciate ligament injury in cattle?

Answer 24

dx: drawer test

tx: cull/salvage, stall rest for 6-9mo, extra-articular plication, CCL replacement

Question 25

what is this?

Answer 25

craniodorsal coxofemoral luxation

Question 26

which is worse, craniodorsal or cranioventral coxofemoral luxation?

Answer 26

ventral - worse bc you get nerve damage

Question 27

how do you tx coxofemoral luxation?

Answer 27

closed or open reduction

Question 28

upward fixation of the patella (dorsal luxation) is common in ____ cattle. what are the C/S?

Answer 28

beef (esp Bos indicus)

limb locks in extension, intermittent but may progress

Question 29

how do you tx upward fixation of the patella

Answer 29

medial patellar ligament desmotomy

Question 30

with lateral or medial patellar luxation, what are the C/S?

Answer 30

unable to extend stifle and bear weight

Question 31

which is more common, lateral or medial patellar luxation?

Answer 31

lateral

Question 32

how do you tx lat/med patellar luxation? what is the px?

Answer 32

tx: sx
px: based on grade (I-IV) –> better for grade I/II

Question 33

what are the general indicators of MSK injury/dz?

Answer 33

• pain
• lameness
• swelling
• fx
• laceration
• down cow
• posture changes
• discharge