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117 Cards in this Set
- Front
- Back
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-A: Vascular channels
-B: Palmar process |
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-A: Extensor process
-B: Palmar process |
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Diseases of the Pedal Bone
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-Fractures
-Laminitis -Pedal Osteitis (infectious/non-infectious) |
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Pedal Bone
-Type I Fracture |
-non-articular palmar process
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Pedal Bone
-Type II Fracture |
-axially located
-intra-articular |
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Pedal bone
-Type III Fracture |
-midline sagittal fracture
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Pedal Bone
-Type IV Fracture |
-Extensor Process
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Pedal Bone
-Type V Fracture |
-Comminuted Fracture
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Pedal Bone
-Type VI Fracture |
-Solar Margin Fracture
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Pedal Bone
-Type VII Fracture |
-Palmar process fractures in foals
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Name the Fractures
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-A: Type I
-B: Type II -C: Type III -D: Type IV |
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Why might Type VI fractures of P3 be missed on a radiograph?
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-if the radiograph is overexposed the solar margin may be burned out
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Type VI P3 Fractures
-Common Causes |
-Pedal Osteitis
-Laminitis |
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Name the Fracture Type
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-Type IV
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Name the Fracture Type
-presenting condition |
-Type VII
-Foal Bilateral Forelimb lameness |
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What may an osseous fragment at the extensor process of P3 represent?
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-acute or chronic fracture (Type IV)
-a separate center of ossification -mineralization within the extensor tendon -normal variation |
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Why is radiographic followup of a P3 fracture challenging?
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-most often heals by fibrous union
-if fracture line is evident by 6-9 months then bony union will probably not occur |
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What should you consider laminitis to be if radiographic signs are visible?
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-chronic
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Radiographic signs of laminitis
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-thickening of the dorsal hoof wall (> 20 mm)
-Palmar rotation of P3 -Indistinct dorsal surface of P3 -Increased number of vascular channels directed to the dorsal surface of P3 -Remodeling and/or pathologic fracture of the toe -Sinking of P3 -Increased founder distance (>1 cm between proximal hoof wall and proximal extensor process) -Linear lucency in the soft tissues of the dorsal hoof wall -Opaque soft tissue band at the level of the coronary band, followed by a depression in the soft tissues just proximal to the coronary band |
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Non-Infectious Pedal Osteitis
-cause |
-response of the P3 to inflammation
-diffuse or focal demineralization |
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Non-infectious Pedal Osteitis
-radiographic changes |
-irregularity of the solar margin
-Increased number and size of the vascular channels in P3 -Generalized loss in bone density -remodeling of the toe -tiny vascular channels radiating through the dorsal cortex of P3 -Bony response on the dorsal surface of P3 |
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Name the condition
-why |
-non-infectious pedal osteitis
-abnormal widening of the vascular channels in P3 |
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Name the condition
-why |
-non-infectious pedal osteitis
-yellow: remodeling of the toe -orange: vascular channels in the dorsal cortex of P3 and a faint bony response |
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Why is infection of the P3 termed osteitis and not osteomyelitis?
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-P3 does not have a medullary cavity
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Infectious pedal osteitis
-cause |
-penetrating wounds
-sub-solar abcess formation |
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Infectious Pedal Osteitis
-radiographic findings |
-focal areas of bone lysis
-sequestrum formation -possible gas in soft tissues |
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How do you know if the presence of gas on a radiograph is due to a sub-solar abcess?
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-if you know that packing of the hoof was completed correctly
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Normal nutrient foramen locations of P1
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-mid-diaphyseal dorsal cortex (lateral)
-distal 1/3 of palmar cortex (lateral) -circular; mid-diaphyseal (doral-palmar) |
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Name these normal structures of P1
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-yellow: oblique sesamoidean ligament attachment
-orange: collateral ligament for digital interphalangeal joint |
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Degenerative Joint Disease
-aka |
-Osteoarthrosis
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Degenerative Joint Disease is secondary to what diseases?
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-trauma
-joint instability -poor confirmation -infection -developmental orthopedic disease |
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Degenerative Joint Disease
-Radiographic findings |
-periarticular osteophyte formation
-enthesophytes -joint space width changes -subchondral bone lysis or sclerosis -soft tissue swelling |
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Enthesophyte
-definition |
-new bone formation at the site of soft tissue attachment
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Classify the condition
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-Severe Degenerative Joint Disease
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Classify the Condition
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-Moderate Degenerative Joint Disease
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Most common fractures of P1 and P2
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-chip fracture of the proximal, dorsomedial ridge of P1
-spiral/longitudinal sagittal fracture of P1 -comminuted fracture of P2 |
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Classify the condition
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-Chip fracture of P1
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What are chip fractures of P1 most commonly due to?
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-overextension injuries
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Classify the condition
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-comminuted fracture of P2
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Flexural defomities
-location |
-most common at distal interphalangeal joint
-can occur at proximal interphalangeal joint |
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Flexural deformities
-cause |
-congenital
-acquired |
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Deformity of the distal interphalangeal joint
-due to |
-contracture (or decreased length relative to bone growth) of the deep digital flexor tendon and/or the inferior check ligament
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Flexural deformities
-radiographic findings |
-vertical orientation of the hoof wall relative to the ground
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Classify the condition
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-flexural deformity of the distal interphalangeal joint
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Classify the condition
-due to |
-luxation
-due to deep digital flexor tendon disruption |
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Navicular degeneration vs. Navicular Disease
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-Navicular degeneration: radiographic change
-Navicular disease: clinical disease |
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Name the radiographic view
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-skyline view
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Navicular degeneration
-radiographic findings |
-erosive lesions of the flexor cortex
-cystic lesions within the body of the navicular bone -sclerosis of the medullary cavity, with loss of corticomedullary definition -increase in the number, size, shape of synovial invaginations -fractures/avulsions of the distal flexor border of the navicular bone (impar ligament) -osteophyte/enthesophyte production and remodeling at the proximal border and extremities of the bone -mineralization of the distal sesamoidian (impar) ligament |
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Navicular bone
-ligament attached to the distal flexor border |
-distal sesamoidean ligament (impar ligament)
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Navicular bone infection
-name of condition |
-osteomyelitis
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Navicular bone osteomyelitis
-secondary disease to |
-penetrating wound
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How to determine if the navicular bone or bursa was involved in a penetrating wound
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-Fistulography
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Fistulography
-definition |
-intraduction of positive contrast in a wound or drainage tract
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Osteomyelitis of the navicular bone
-radiographic findings |
-sclerosis or lysis of the bone (flexor cortex)
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Navicular Bone Fracture
-reason for a false positive diagnosis |
-improper packing leading to overlying sulcus artifact
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Where should fractures of the navicular bone be confined to?
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-margins of the navicular bone
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What can be done helpful for cases where a navicular bone fracture is expected but cannot be confirmed on the initial radiograph examination?
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-re-evaluation in 10-14 days
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Navicular bone fracture
-method of healing |
-fibrous union
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Multipartite
-definition |
-multiple areas of ossification
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Osseous fragments at the distal border of the navicular bone
-causes |
-chip fracture (avulsion of impar ligament)
-separate centers of ossification within the impar ligament -mineralization of synovium |
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Classify the condition
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-fracture of the navicular bone
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Soft tissue swelling over the dorsal surface of the Metacarpus, or Metatarsus
-reason |
-periostitis
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Soft tissue swelling on the palmaroplantar surface of the Metacarpal, or Metatarsal bone/joint
-reason |
-flexor tendon abnormality
-suspensory desmitis |
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Soft tissue swelling of the Metacarpus, or Metatarsus
-causes |
-trauma
-infection |
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Most common form of soft tissue mineralization of the Metacarpal, or Metatarsal region
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-Dystrophic mineralization
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Reason for periosteal reastion on the dorsal surface of MCIII
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-response to microfractures
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Why might periosteal reaction occur between MCII and MCIII or between MCIII and MCIV?
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-interosseous ligament damage
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Classify the condition
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-periosteal reaction
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Most common location for metacarpal/metatarsal fractures
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-distal half of the splint bones
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Most common location for incomplete/stress fractures of Metacarpals/Metatarsals
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MCIII or MTIII:
-distal condyle of MCIII -Dorsal cortex -Palmaroplantar cortex |
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Sesamoid fracture types
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-apical
-mid-body -basilar |
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Abaxial sesamoid fracture
-cause |
-avulsion fracture from suspensory ligament
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Classify the condition
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-apical fracture of the sesamoid
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Differential for mineralization of soft tissue around the Metacarpal/Metatarsal joints
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-cortisone arthropothy (injection of steroids)
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Osteocondrosis of Metacrapals/Metatarsals
-common cause |
-abnormal endocondral ossification
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Why should images of the contralateral limb always be taken with suspected osteocondrosis of the metacarpals/metatarsals?
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-commonly occurs bilaterally
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Osteochondrosis of metacarpals/metatarsals
-radiographic findings |
-subchondral bone lucency
-flattening with adjacent sclerosis -defect/irregularity in subchondral bone -osseous fragment possibly present -osseous cyst-like lesion |
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Common locations of osteochondrosis in the metacarpophalangeal joint
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-sagittal ridge of MCIII/MTIII
-distal condyle of MCIII/MTIII -proximal phalynx -palmar eminence of the proximal phalanx |
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Classify the condition
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-Subchondral cysts
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Sesmoiditis
-location of normal association with degenerative change |
-suspensory ligament
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Sesmoiditis
-radiographic findings |
-bony proliferations on the non-articular margins of the proximal sesamoids
-linear or cystic lesions in the abaxial surface -lysis in the axial margins associated with disease of the intersesamoidean ligament |
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Classify the condition
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-Sesmoiditis
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Sequestra
-Most common location |
-distal extremities
-areas where little soft tissue is covering bone |
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When does a sequestra form?
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-when a portion of the bone becomes avascular
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Sequestra
-radiographic findings |
-sharply marginated, sclerotic fragment
-fragment separated by the parent bone by a zone of lucency and outer rim of sclerotic bone -draining tract (cloaca) may be present |
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Classify the condition
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-sequestra
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Classify the Structure
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-chestnut
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Carpus
-Intra-capsular swelling differentials |
-synovitis
-osteoarthrosis -fracture -sepsis |
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Carpus
-Extra-capsular swelling differentials |
-hygroma
-tendon disease -abscess -cellulitis |
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Hygroma
-definition |
-subcutaneous synovial bursa that forms as a result of trauma
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If a swelling is centered around 1 joint margin, what kind of swelling is it most likely?
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-intra-capsular
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Carpus fracture
-concurrent condition that is usually present |
-soft tissue swelling
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Carpus fracture
-types |
-chip
-corner (large chip) -slab |
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Carpus fracture
-common locations of chip fractures |
-dorsodistal surface of the radium
-dorsodistal margin of the radial carpal and intermediate carpal bones -proximal 3rd carpal bone -dorsoproximal intermediate and radial carpal bones |
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Carpus fracture
-most useful views for chip fractures |
-flexed lateral
-oblique |
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Carpus fracture
-most common slab fracture |
-3rd carpal bone
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-A: 4th carpal
-B: 3rd Carpal -C: 2nd carpal |
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Classify the condition
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-dorsal slab fracture
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Classify the condition
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-parasaggital slab fracture
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Effect of stress from training on the carpal bones
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-sclerosis of the 3rd carpal bone
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3rd Carpal bone Sclerosis
-view necessary to detect -other findings |
-skyline view of the distal row of carpal bones
-lose normal trabecular pattern of bone -lose distinction between cortical and medullary bone |
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Classify the condition
-why |
-Degenerative Joint Disease of the carpus
-heterogenous opacity -periarticular osteophytes |
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Angular limb deformity
-radiographic findings |
-physitis
-wedging of the distal radial epiphysis -incomplete cuboidal bone ossification or malformation |
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Physitis
-defintion |
-irregularity with asymmetrical widening of the distal radial physis, metaphyseal and epiphyseal flaring, and cortical thickening)
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Classify the condition
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-angular limb deformity
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Osteochondrosis of the Tarsus
-common locations |
-Distal Intermediate Ridge of the Tibia (DIRT)
-Medial and Lateral Trochlear Ridges |
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Radiographic view
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-DMPLO
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Classify the Condition
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-DIRT lesion (arrow)
-osteochondrosis of the Tarsus |
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View where it is easiest to view a DIRT lesion
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-DMPLO
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Radiographic View
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-DLPMO
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If a fracture of the Tarsus is difficult to detect, what should be done?
-why? |
-radiographic reassessment in 7-14 days
-allows time for bony remodeling to occur at the fracture site |
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Classify the Condition
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-Slab fracture of the tarsus
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Classify the condition
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-ankylosis from osteoarthrosis (DJD)
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Cause of septic arthritis in foals
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-hematogenous spread
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Cause of osteomyelitis in adult horses
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-penetrating wounds
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Septic Arthritis
-radiographic findings |
-joint effusion
-subchondral bone lysis -collapse of the joint |
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Classify the condition
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-Septic arthritis with osteomyelitis
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