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83 Cards in this Set
- Front
- Back
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joints of the hock
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- tibiotarsal: joint with primary motion; communicates with the proximal intertarsal joint
- proximal intertarsal: communicates with tibiotarsal - distal intertarsal: in some horses communicates with tarsometatarsal jt - tarsometatarsal: in some horses communicates with the distal intertarsal jt |
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joints involved in bone spavin
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proximal intertarsal. distal intertarsal, tarsometatarsal jts
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CS bone spavin
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- chronic condition
- reduced flexion of the hock. drag the toe and dive toe into the ground - horse warms out of the lameness - lame leg closer to the midline |
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Dx bone spavin
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- rxn to an upper limb flexion test, less lame leg first: hold for 2 mins and trot immediately
- decrease in lameness following tibial and deep peroneal nerve blocks - rad changes routinely present on the cranial medial aspect of the jts - scintigraphy |
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medical management for bone spavin
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- NSAIDS: phenylbutazone
- intraarticular hyaluronate - IM Adequan - intraarticular corticosteroids - excessive rest is of limited value - shock wave therapy has been reported to decrease lamaness |
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surgical management of bone spavin
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- corrective shoeing: square the toe, lateral trailer on shoe
- cunean tenotomy to relieve P on distal hock jts and the cunean bursa (not of significant value) - surgical arthrodesis of the distal hock jts (destroying the cartilage in tarsometatarsal and distal intertarsal jts) + small pen exercise for 4 mo - injection of irritants: monoiodoacetate, 70% ethyl alcohol + stall rest |
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description: bog spavin
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synovial fluid distention of the tibiotarsal jt
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CS bog spavin
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- many times animal is not lame
- dvps acutely - distended tibiotarsal jt most obvious on the anterior medial aspect of the jt |
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Dx and rule outs bog spavin
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- CS
- rads to r/o fx or osteochondrosis - palpation to r/o thoroughpin - cytology of synovial fluid to r/o jt infection |
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animals affected by tarsal bone necrosis and collapse
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neonatal foals
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etiology of tarsal bone necrosis and collapse
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congenital pbm
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description: curb
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desmitis of the plantar ligament on the plantar aspect of the hock
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etiology of curb
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- trauma (excess kicking)
- poor conformation (sickle or cow hocks) |
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CS OCD of the tarsus
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- distention of tibiotarsal jt
- lameness may or may not be present - usually not markedly lame |
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most common areas of involvement with OCD of tarsus (in order of decreasing frequency)
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seen on radiographs:
- cranial distal aspect of the intermediate ridge of the tibia - lateral trochlear ridge of the talus - medial trochlear ridge of the talus - medial and/or lateral malleolus of the tibia |
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management of OCD of tarsus
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- lame + jt effusion: arthroscopic Sx to remove fragments + curette involved area
- no lameness or effusion: no surgery |
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description: capped hock
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swelling involving a subcutaneous bursa at the point of the hock
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management of chronic cases of capped hock
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- draining and injections
or - do nothing and allow swelling to persist or - surgical removal of all involved tissue and limit motion with cast |
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description: luxation of the superficial flexor tendon
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superficial flexor tendon attachments to the tuber calcis are disrupted
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etiology luxation of the superficial flexor tendon
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trauma causing rupture of the medial or less commonly the lateral attachment of the tendon to the tuber calcis
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CS luxation of the superficial flexor tendon
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- marked initial swelling (can be confused with capped hock)
- significant lameness shortly after condition occurs, can improve over time - tendon movement: tendon slips off of the tuber calcis (usually laterally) |
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description: thoroughpin
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idiopathic distention of the sheath of the deep flexor tendon (tarsal sheath) just anterior to the SDF tendon: synovial effusion without inflammation
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management: thoroughpin
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- considered a blemish
- removal of excess synovial fluid - P bandage |
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description: stringhalt
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abnormal gait in which there are varying degrees of hyperflexion of the rear limb
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etiology stringhalt
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- dandelions (bilateral)
- sporadic (unilateral) |
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when is stringhalt worse
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- in cold weather
- when the animal backs - when the animal turns - after the horse has rested |
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management stringhalt
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- removal from dandelions
- lateral digital extensor tenectomy (divide tendon distally while still attached proximally) |
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description fibrotic and ossifying myopathy
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condition which causes an alteration in the gait that is seen only when the animal is walking
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etiology fibrotic and ossifying myopathy
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trauma and healing with fibrosis and/or ossification of the semitendinosis, semimembranosus and/or biceps femoris muscles
(kicks, trailer injuries, injections) |
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CS fibrotic and ossifying myopathy
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limb is pulled to the rear just prior to the foot hitting the ground when walking
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Dx fibrotic and ossifying myopathy
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palpation of fibrotic or ossified muscles caudal to the stifle
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management fibrotic and ossifying myopathy
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- partial myectomy (not recommended)
- transection of the insertion of the tendon of the semitendinosus muscle at the caudomedial aspect of the proximal tibia (post op stall rest 14d) |
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prognosis fibrotic and ossifying myopathy
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partial myectomy effective in 50 % of cases
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CS OCD of trochlear ridge of femur
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- young animals 6 mo to 2 yrs
- synovial effusion of femoropatellar jt - slight to moderate lameness (decreased anterior phase of stride, increased lameness with flexion test) |
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conservative management of OCD of trochlear ridge of femur
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- 40-60% success rate
- rest, turn out to pasture - reduce concentrates - correct mineral balance |
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surgical management of OCD of trochlear ridge of femur
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recommended if athletic career is anticipated
- remove fragments and debride the base of lesions - use arthroscope |
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prognosis OCD of trochlear ridge of femur
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- good if only lateral ridge is involved
- less favorable if medial and lateral ridges involved |
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CS subchondral cystic lesion of the medial femoral condyle
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- intermittent insidious gait abnormality
- between 5 mo and 5 years of age - first noticed when horse is put to work - usually no synovial effusion |
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Dx subchondral cystic lesion of the medial femoral condyle
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- articular injection of anesthetics doesn't result in a change in the lameness in most cases (cyst does not always communicate with the jt)
- upper leg flexion tests increase the lameness - rads: PA view, typically see circumscribed subchondral lucency with surrounding sclerosis |
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management subchondral cystic lesion of the medial femoral condyle
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conservative:
- rest on pasture - restrict concentrated feed - balance mineral intake - 40-60% success surgical (if athletic career) - curette the cystic lesion with arthroscope, intra-articular Depo-Medrol post-op |
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description: upward fixation of the patella
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medial patellar ligament becomes fixed proximal to the medial condyle of the femur
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CS of complete upward fixation
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leg is in an extended position and cannot be flexed:
- most commonly in draft horses |
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management acute upward fixation of the patella
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- back horse up
- startle so that it jumps back quickly - attach sideline to pastern, pull leg fwd while forcing patella medially and distally - consider medial patellar desmotomy if conservative methods not effective |
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management of momentary upward fixation of the patella
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- slowly increase exercise to condition and tone muscles (cross country rides)
- inject patellar ligaments with mild irritants (iodine in almond oil) - medial patellar desmotomy (1st time and repeat Sx) without rest post-op - splitting the patellar ligaments |
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description: bone spavin
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- spavin is a broad term that is used to describe hock lameness
- bone spavin is an osteoarthritis involving any of the 3 distal hock joints |
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etiology: bone spavin
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this is a wear and tear condition that is a greater problem but definitely not limited to animals with poor conformation: upright or sickle hocks
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auto-management of bone spavin
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- with continued exercise some animals will irritate the involved joints until DJD become so severe that ankylosis occurs and the animal becomes using sound
- these are joints that the horse does not need - when ankylosis occurs, the animal usually becomes sound if lameness is due to osteoarthritis in the joints |
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prognosis: bone spavin
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- many animals can continue in use for prolonged periods of time with the use of analgesics
- it is possible for the distal joints to undergo ankylosis - usually takes considerable time - arthrodesis will many times allow continued use of the animal - monoiodoacetate can be up to 80% succesful but can have severe complications - surgical arthrodesis 60% success with minor complications |
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etiology bog spavin
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- trauma
- osteochondrosis - uneplained: young fast growing animals, straight hocks |
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prognosis:bog spavin
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- lameness is usually not present so treatment is just to reduce the blemish
- some untreated animals will return to normal without long-term jt effusion - if therapy is not early and aggressive, it is common for the joint swelling to persist |
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CS: tarsal bone necrosis and collapse
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swelling pain and excess angularity of the hock
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Dx tarsal bone necrosis and collapse
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rads show degeneration of the 3rd tarsal bone
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management tarsal bone necrosis and collapse
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- tube casts might be of value in supporting the joints until they fuse
- these cases don't routinely respond - euthanasia is a viable option |
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CS curb
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- firm swelling over the plantar aspect of the hock
- lameness and pain on palpation of the area in acute stage |
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management of curb
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- NSAIDs
- topical DMSO - local injection of corticosteroids - after initial inflammatory response subsides: sweats (mild irritants), firing and blistering recommended but probably of little value |
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prognosis: curb
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- usual for animal to return to athletic soundness
- common for the swelling to persist |
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description: osteochondrosis dissecans of the tarsus
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unhealthy subchondral bone resulting in unhealthy cartilage
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etiology: OCD of the tarsus
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associated with:
- nutritional excess - rapid growth: genetic predisposition - trauma - copper deficient diets - high Ca diets - high phosphorus diets - zinc excess |
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prognosis: OCD of the tarsus
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good for return to athletic soundness if properly managed
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etiology: capped hock
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usually associated with horse that is a "kicker", associated with excessive kicking of stall walls and trailers
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CS capped hock
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- swelling involving a bursa at the point of the hock
- mild cases: swelling usually subsides in several days - chronic problems: thickening of the tissue with or without fluid accumulation |
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management: acute cases of capped hock
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- needle aspiration of the accumulated fluid
- injections as in bog spavin - snug bandage |
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prognosis: capped hock
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guarded for reduction of swelling
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Dx luxation of the superficial flexor tendon
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- CS
- radiographs to rule out osseous involvement |
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management: luxation of the superficial flexor tendon
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implanting mesh and immobilisation with a cast for 30 to 60 days
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prognosis: luxation of the superficial flexor tendon
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- few surgical cases have been reported
- fair success reported |
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etiology: thoroughpin
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thought to be the result of chronic low grade trauma
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CS thoroughpin
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- distention of the sheath of the deep flexor tendon
- usually lameness is not present |
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prognosis: thoroughpin
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distention quite commonly persists
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Dx stringhalt
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- CS
- r/o other problems: occasionally animals with rear leg pain show this abnormal motion |
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prognosis: stringhalt
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most animals will show significant improvement and a number return to normal following lateral digital flexor tenectomy
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etiology: OCD of the trochlear ridge of the femur and subchondral cystic lesions of the medial femoral condyle
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theories include:
- nutrition - rapid growth rate - genetic predisposition - trauma - copper deficiency |
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Dx OCD of the trochlear ridge of the femur
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- CS
- radiographs: irregularity or flattening of the trochlear ridge (usually lateral) and joint mice - local anesthetics infused into the joint reduces lameness |
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description: subchondral cystic lesions of the medial femoral condyle
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cystic lesions involving the medial femoral condyle
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prognosis: subchondral cystic lesions of the medial femoral condyle
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- good if the lesion is not severe
- poor if degenerative joint disease is present - soudness is not dependent on radiographic evidence of the cyst filling |
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etiology: upward fixation of the patella
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- possible hereditary predisposition associated with straight hindlimb conformation
- trauma associated with overextending the limb - poor conditioning and as a result of muscle spasm (complete upward fixation used to occur in the spring in farming days) |
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Dx upward fixation of the patella
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- evidence of CS
- complete upward fixation is very evident - momentary fixation is more difficult to diagnose |
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prognosis upward fixation of the patella
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depends upon the individual animal the procedure performed and the aftercare: can usually be successfully resolved
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chars rupture of the peroneus tertius
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- the muscle routinely ruptures distally in adult horses
- young foals frequently have avulsion fractures at the attachment to the distal femur |
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etiology: rupture of the peroneus tertius
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usually associated with over-extension of the carpus and flexion of the stifle
- getting the rear leg caught and maximal exertion to free the limb - slipping and markedly extending the tarsus with the stifle flexed |
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CS: rupture of the peroneus tertius
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- flexion of the stifle without flexion of the hock
- when the hock is flexed the Achilled tendon will be flaccid with a dimple occuring just proximal to the tuber calcis |
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Dx rupture of the peroneus tertius
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- PE showing classical CS
- animal will bear weight normally - when moved at a walk there will be some difficulty in advancing the limb - when moved at a trot there is a markedly apparent lameness because the limb will not be advanced normally |
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management: rupture of the peroneus tertius
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- when rupture is in the distal portion of the muscle: 3 months stall rest, good prognosis
- when avulsion injuries occur: stall rest is indicated but prognosis is not good for return to complete soundness |
