Tarsal Joint 1 Flashcards
How many major joints are within the tarsus?
6
What are the 6 tarsal joints?
Tarsocrural
Talocalcaneal
Talocalcaneocentral
Calcaneoquartal
Centrodistal
Tarsometatarsal
Which 2 joints for the proximal intertarsal joint?
Talocalcaneocentral
Calcaneoquartel
What is the Centro distal joint also known as?
Distal intertarsal joint
What is the proximal row of the tarsus composed of? (2)
Talus
Calcaenous
Does the talus or calcaneus form an articulation with the tibia + fibula
Talus
The fourth tarsal bone spans the distal intertarsal joint from the A) to the B) .
A) calcaneus
B) metatarsals
The central tarsal bone articulates with all the other tarsal bones:
A) What does it act as?
B) What is the role?
A) Buttress
B) Support the joint
Where does the common calcanean tendon insert?
On the tuber calcaneus
Where does the tarsal joint capsule extend from and to?
FROM: Distal tibia
TO: Proximal metatarsals
The tarsal joint capsule is thickened on dorsal and plantar aspect - where is it MORE developed?
Plantar
The tarsal canal forms from divided plantar fascia and contains:
A) Which tendon sheath?
Flexor hallucis longus m
The tarsal canal forms from divided plantar fascia and contains:
Which vasculature?
Plantar branches of saphenous a and v
The tarsal canal forms from divided plantar fascia and contains:
Which nerves
Medial and lateral plantar nerves
What is the mediolateral support of the tarsus by?
Medial and collateral collateral ligaments
When do the long part of the medial and lateral collateral ligaments provide support?
When hock is extended
What are the 2 bands of the short part of the medial and lateral collateral ligaments MEDIALLY?
Tibio central
Tibiotalar
What are the 2 bands of the short part of the medial and lateral collateral ligaments LATERALLY?
Calcaneofibular
Talofibular
Which short parts of the medial/lateral collateral ligaments provide support in extension?
Tibiocentral
Calcaneofibular
Which short parts of the medial/lateral collateral ligaments provide support in flexion?
Tibiotarsal
Talofibular
Plantar ligaments are important stabilisers of which aspect?
Plantar
What are the 3 major components of the plantar ligament?
Medial
Lateral
Middle plantar
Tarsal ROM in dogs:
A) Flexion?
B) Extension?
A) 39
B) 164
Tarsal ROM in cats:
A) Flexion?
B) Extension?
A) 22
B) 167
“The common calcanean tendon should be palpated from the musculotendinous junction proximally to the calcaneus distally.” Is this true or false?
True
How should the common calcanean tendon appear on CE?
- Well define
- Non painful
- Taught when weight beairng
What are the minimum xray views that should be taken of the tarsus?
mediolateral and extended plantarodorsal projections
Other than xrays:
Other possible tarsus investigations? (3)
CT
Synoviocentesis (tarsal arthroscopy challenging)
MRI
Where is the incision on the Medial Approach to the Tarsal Joint?
Curved;
Centred over medial part of talocrural joint from the distal 4th - distal metatarsal joint
What is Exposed after incision of the subcutaneous and crural fasciae on the Medial Approach to the Tarsal Joint?
the medial ridge of the talus
Where/how is the joint capsule incised on the Medial Approach to the Tarsal Joint?
Parallel to the collateral ligament and distal on the talar neck.
on the Medial Approach to the Tarsal Joint how is the plantar aspect accessed?
Incision of the joint capsule plantar to the collateral ligament
on the Medial Approach to the Tarsal Joint how can the tendons of the tibial caudalis and deep digital flexor muscles be protected?
By incising the overlying medial retinacular tissues parallel to the tendons.
How is the skin incision made on the Lateral Approach to the Tarsal Joint?
Make a curved skin incision over the lateral surface of the talocrural joint from the lateral saphenous vein to the tarsometatarsal joint.
Where are the the fascia (subcutaneous and crural) and the extensor retinaculum incised with Lateral Approach to the Tarsal Joint?
Parallel to the dorsal border of the fibularis longus tendon.
On the Lateral Approach to the Tarsal Joint how is the joint capsule incised to approach the lateral trochlear ridge?
With the tarsal joint in extension dorsal and parallel to the collateral ligament
On the Lateral Approach to the Tarsal Joint how is the joint capsule incised to approach the [plantar aspect of the lateral trochlear ridge
tarsal joint in flexion after retracting the fibularis brevis and lateral digital extensor muscle
Lateral Approach to the Tarsal Joint involves elevation of the lateral extensor retinaculum; you must take care to preserve..?
short, deep part of the lateral collateral ligament.
How common is the tarsus for OCD lesions in dogs/cats?
3rd most common
Osteochondrosis of the tarsus most commonly involves the A) ridge of the talus, although the B) ridge of the talus is occasionally affected.
A) Caudomedial
B) Lateral
Breeds most commonly effected by OCD of the tarsus? (3)
Rottweiler
Labrador
Bull terrier
Age of presentation with OCD?
5-9mo (although can be missed so seen for 2ry OA)
There is evidence of hereditary aetiology of tarsal OCD in which breed?
Rottweiler
What do owners frequently report with tarsus OCD?
The patient is stiff in the morning, or after rest, and that the lameness worsens after exercise.
Dogs with osteochondrosis of the talus have been reported to have what clinical finding with the tarsus?
Hyperextended
OCD of the tarsus :
Where is there often swelling?
Caudomedial tarsocrural joint
Tarsus OCD:
What is found with flexion?(2)
Reduced
Forced flexion - pain
Common tarsus OCD clinical findings?
Crepitus (flex + extend)
Joint effusion
Periarticular swelling
Reduced ROM
Why should both tarsal joint be xrayed?
Bilateral dx - common
On the plantarodorsal projection; what is normally seen? (2)
-Flattened medial trochlear ridge
- Increase medial tarso crural joint space
OCD where are osteophytes normally evident on plantar dorsal view?
Medial aspect of the talus
OCD in the tarsus - what can be seen on the mediolateral projection?(2)
Flattening of the trochlear ridge
Osteophytes evident at the caudal aspect of the distal tibia.
On the mediolateral projection; where may a mineralised fragment may, in some cases?
Caudal and proximal to talus
Why is OCD of the lateral talar ridge more difficult to diagnose?
Superimposition of calcaneous
IS CT required for diagnosis of osteochondrosis of the medial talar ridge?
Can be used for early identification of the lesion but is not normally required
When is CT superior for detecting OCD of talar ridge?
Lateral edge
When is removal of an OCD lesions recommended?
Via what procedure?
Young dogs (10-12mo)
- Arthroscopy or arthrotomy
In older dogs with OA; what is the treatment ?
Medical management (e.g. exercise restriction followed by exercise modification, NSAIDs, body weight control) can be recommended in older dogs with established osteoarthritis.
What procedure can be considered in dogs with intractable pain or lameness due to the secondary osteoarthritis?
Pantarsal arthrodesis
Prognosis for talar osteochondrosis?
guarded as most dogs remain lame
True or false:
In older dogs, removal of the Talar OCD flap often results in no improvement at all.
True
Why are many clinicians are moving away from surgery and treating all dogs with tarsal osteochondrosis non-surgically?
Osteoarthritis progresses despite surgery
