Tendon Diseases Flashcards
SDFT tendinitis in the horse
Acute lameness
Flexor tendon sheath effusion + carpal sheath effusion
Fetlock sinking p
Dx: core lesions in the tendon
Tx: cold hosing, NSAIDs, support dressing, box rest 6w Tendon splitting Stem cells and PRP Ultrasound therapy Early light exercise Controlled exercise programme
Monitor healing using ultrasound over 6-9 months
Accessory ligament desmitis
Swelling in the proximal metacarpal region
- dorsal to the SDFT on the Palmar aspect of the joint
Moderate to severe lameness
Secondary foot contracture
Dx: ultrasound shows core lesions
Tx: cold hosing, NSAIDs, rest, controlled exercise
Surgical desmotomy
Guarded px - recurrence common and secondary foot contractures
Suspensory ligament desmitis
Injury most commonly at the origin and proximal part of the SL
+/- concurrent bony damage - avulsion fx / enthesiopathy
Unilateral - more acute
Bilateral - more chronic = vague poor performance
CE - acute - swelling, pain and heat
Chronic - often no findings
Localise with nerve blocks
Dx: US - enlargement, poor margination, reduced or increased echogenicity, oedema
Tx: rest, controlled exercise, NSAIDS PRP and stem cells Shockwave therapy Ligament splitting Neurectomy / fasciotomy - covered by a ligament which creates pressure and compresses the nerve supply
Causes of flexor tendon sheath effusion?
SDFT tear - manica flexoria
DDFT tear
PAL desmitis
Sepsis
Proximal annular ligament syndrome
CS: digital flexor tendon sheath effusion
Notching of the ligament due to PAL constriction
Mild to moderate lameness
Pain on flexion
Positive response to digital flexor tendon sheath analgesia or peri-neural analgesia
Imaging - assess tendons and PAL
Tx: cold hosing, NSAIDs, rest, controlled exercise NSAIDs Corticosteroids in the tendon sheath Tenors copy PAL Desmotomy
Upwards fixation of the patellar
Medial pole of the patellar hooks over the medial trochlear as part of the stay apparatus
- but can’t be unlocked by the usual quadriceps mechanism due to muscle wastage
Seen in:
Horses on box rest
Poorly muscled animals
Straight hocked conformation
CS: limb locked in extension and toe dragged - dorsal wear of toe
Tx: exercise to build up muscle, tx concurrent problem
Splitting or injecting medial patellar ligament
Medial patellar desmotomy
Rupture of the peroneus tertius
Avulsion / rupture during hyperextension
CS: extended hock and stifle flexed - toe dragged
Guarded prognosis - minimum of 6-8 weeks box rest
Luxation of the SDFT from the point of the hock
Traumatic
Usually due to tearing of the medial ligament so displaces laterally
Acute calcanean bursa effusion
SDFT slips off the tuber calcis at walk = painful
Tx: conservative for 3-6 months