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Large Animal Surgery > Disorders of the Equine Hindlimb > Flashcards

Disorders of the Equine Hindlimb Flashcards

1
Q

What are the 3 most common etiologies of cervical spine OA? What are the most common signs?

A
  1. trauma
  2. unnatural head carriage
  3. osteochondrosis

stiff neck +/- lame or neurologic

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2
Q

What are 3 options for treating cervical spine OA? What is prognosis like?

A
  1. inject facets with corticosteroids
  2. acupuncture
  3. mesotherapy

fair - requires lifelong maintenance, can progress and cause neurologic signs

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3
Q

What is mesotherapy? What is injected?

A

treatment for cervical spine OA that blocks pain through the dorsal nerve root through A-beta fibers

saline, local anesthetic, and/or steroids

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4
Q

What are the 2 most common causes of impinging dorsal spinous processes? What are 3 signs?

A

kissing spines - trauma or poor fitting saddle

  1. pain on palpation
  2. reduced performance
  3. behavior change
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5
Q

What are 3 options for treatment of impinging dorsal spinous processes?

A
  1. check and fix saddle fit
  2. inject area with corticosteroids
  3. surgical resection between processes to relieve impingement
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6
Q

What are the 4 most common causes of general back muscle pain in horses? What are 2 signs?

A
  1. underlying hind limb lameness*
  2. poor saddle fit
  3. poor riding
  4. trauma

pain on palpation + reduced performance

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7
Q

What 2 types of saddle fits can lead to general back pain?

A
  1. bridging - increased pressure on edges
  2. rocking - increased pressure on the center
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8
Q

What are 4 options for treating general back muscle pain? What is prognosis like?

A
  1. check saddle fit
  2. inject area with corticosteroids - mesotherapy
  3. acupuncture
  4. rest

good once underlying cause is addressed

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9
Q

What are the 4 most common signs of sacroiliac disease? What are 2 possible causes?

A
  1. arthritis
  2. subluxation of SI joint - “hunter’s bump”
  3. acute lameness
  4. crepitus on rectal palpation

trauma, inappropriate use

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10
Q

How is sacroiliac disease diagnosed? Treated? What is prognosis like?

A

clinical signs + U/S + hunter’s bump –> area too thick to radiograph

rest + inject joint with corticosteroids

good - typically requires ongoing mainenance

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11
Q

What are the 4 most common structures involved with hindlimb lameness?

A
  1. hock
  2. below hock
  3. stifle
  4. above stifle
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12
Q

What is the most common cause of metatarsal 2 and 4 (splint bones) fractures? How is it diagnosed?

A

kick injury –> from self or pasture mates (mares!)

  • radiographs
  • observe a non-healing wound with sequestration
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13
Q

How are metatarsal 2 and 4 fractures treated? What is prognosis like?

A

segmental or complete ostectomy - only MT4 can be completely removed en bloc; remove the distal part

excellent

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14
Q

When is internal fixation recommended with metatarsal (splint) bone fractures?

A

proximal fractures or MT2 –> main areas of weight bearing

  • ostectomy not recommended!
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15
Q

What are 5 gait characteristics of hock lameness?

A
  1. drags toes - scuffed hoof
  2. fails to “track up” on lame leg
  3. lame leg adducts most
  4. rider field difference in connection
  5. reduced performance
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16
Q

What are 3 possible findings on joint palpation with hock lameness?

A
  1. often nothing
  2. bone spavin - hard swelling
  3. bog spavin - effusion
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17
Q

What are 5 diagnostics used for hock lameness?

A
  1. flexion tests
  2. intra-articular blocks
  3. radiographs
  4. nuclear scintigraphy
  5. CT (?)
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18
Q

What is the most common hind end lameness diagnosed in performance horses? What 2 joints are most commonly affected? Which 2 are less so?

A

hock OA

distal intertarsal and tarsometatarsal joints - most distal, low motion

tibiotarsal and intertarsal - VERY lame, high motion

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19
Q

What are the 2 most common etiologies associated with hock OA? What are 2 signs? How are radiographs used?

A

athletic use and genetic (juvenil spavin)

  1. positive upper limb flexion
  2. BLOCKS to distal hock joints

can observe bone lysis and sclerosis, but does NOT correlate well with clinical lameness

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20
Q

What are 3 options for treating hock OA? What is prognosis like?

A
  1. intra-articular corticosteroids
  2. shoeing - squared toe
  3. facilitates ankyloses or arthrodesis - laser, ethyl alcohol, drilling

good - required ongoing maintenance during career

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21
Q

What is a bog spavin? What are 5 possible etiologies?

A

tibiotarsal effusion

  1. OCD
  2. synovitis - poor conformation, hard work
  3. OA - rare
  4. hemarthrosis - collateral ligament injury
  5. septic arthritis
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22
Q

How are bog spavins diagnosed?

A
  • effusion in TT joint
  • radiographs
  • U/S?
  • arthroscopy
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23
Q

How are bog spavins treated? What is prognosis like?

A

drain joint, inject corticosteroids (may cause more damage!), arthroscopy

good - usually cosmetic problem if underlying issue is addressed

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24
Q

What are the 4 most common locations of hock osteochondrosis?

A

distal intermediate ridge of tibia > lateral trochlear ridge > medial trochlear ridge > medial malleolus

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25
Q

What is a curb? What are the 2 most common etiologies? What horses are over-represented?

A

plantar ligament desmitis

  1. strain on plantar aspect of the hock
  2. sickle hocked horses

Standardbreds

26
Q

What are 2 signs of plantar ligament desmitis? What 2 diagnostics are used?

A
  1. characteristic plantar swelling at the level of the hock
  2. mild to moderate lameness
  • blocks to high 4 and tarsometatarsal
  • U/S
27
Q

How is plantar ligament desmitis treated? What is prognosis like?

A

usually responds well to rest

good - will always have a “curb” welling on plantar hock

28
Q

What is a capped hock? What is the most common etiology? What are the 2 most common signs?

A

calcaneal bursitis

repeated trauma - stall kicking

  1. characteristic swelling at calcaneus
  2. generally NOT lame
29
Q

What treatment can be done for calcaneal bursitis? What is prognosis like?

A

drain and inject corticosteroids –> purely cosmetic, don’t get it infected

excellent (poor for cosmesis)

30
Q

What is the most common etiology of septic calcaneal bursitis? How do horses present? How is it diagnosed?

A

wounds over calcaneus opens up the bursa (common spot to be kicked!)

VERY lame

  • pressurize bursa
  • contrast radiography
  • U/S
31
Q

What are 3 options for treating septic calcaneal bursitis? What is prognosis like?

A
  1. flush bursa - tenoscopy recommended
  2. regional limb perfusion
  3. open bursa and resect part of calcaneus

guarded - hard to clear infection

32
Q

Septic calcaneal bursitis, resection:

A

disrupted portion of calcaneus removed, which can disrupt the stay apparatus –> unlikely to go to work

33
Q

What is a thoroughpin? What are the 2 most common etiologies? 2 signs?

A

tarsal sheath tenosynovitis

  1. wear and tear
  2. conformation - straight hocks
  • characteristic swelling within SDF and DDF, seen on either side of the sheath
  • usually NOT lame
34
Q

What treatment is recommended for thoroughpin? What is prognosis like?

A

none - injecting corticosteroids is risky, bandaging doesn’t help

excellent (poor for cosmesis)

35
Q

Hock blemishes:

A
36
Q

What blemish is seen in this picture?

A

thoroughpin

37
Q

What blemish is seen in this picture?

A

capped hock

38
Q

What blemish is seen in this picture?

A

bone spavin

  • firm!
39
Q

What blemish is seen in this picture?

A

bog spavin

40
Q

What 3 muscles take part in the reciprocal apparatus of the hindlimb?

A
  1. gastrocnemius
  2. superficial flexor musculotendon unit
  3. peroneus tertius
41
Q

What are the 2 most common etiologies of ruptured peroneus tertius? What are 3 signs?

A

trauma in foals or full limb casts

  1. ability to extend hock with a flexed stifle
  2. lameness and swelling (initially)
  3. tarsus extends more than usual at the trot
42
Q

What treatments are recommended for ruptured peroneus tertius? What is prognosis like?

A
  • stall rest
  • avulsions near stifle require arthroscopy

good - poor if involving stifle

43
Q

What is the most common etiology of SDF or gastrocnemius rupture? How are they diagnosed? Treated?

A

trauma

clinical signs + U/S

long-term splinting and rest –> challenging!

44
Q

What gait change is seen with SDF or gastrocnemius rupture?

A

hind limb drops and gets left behind

45
Q

What is fibrotic myopathy? What is the most common etiology?

A

fibrosis +/- ossification of the semitentinosus

trauma - muscle heals with thick, firm, and hard fibrotic tissue

46
Q

What are 2 characteristic signs of fibrotic myopathy?

A
  1. hindlimb floats - unable to flex and extend, causing it to jerk backward; most evident at a walk
  2. palpable hardening in semitendinosus mm
47
Q

What treatment is recommended for fibrotic myopathy? What is prognosis like?

A

semitendinosus +/- semimembranosus tentotomy - minimal side effects, may not result in complete resolution of clinical signs

fair - altered gait likely permanent

48
Q

What is Stringhalt?

A

equine reflex hypertonia - gait abnormality characterized by involuntary, exaggerated upward movement of one or both of the hindlimb

  • jerk or hop, with the affected hindlimb(s) snapped up towards the abdomen
49
Q

What are 3 gait characteristics of stifle lameness? What are the 2 most common clinical signs?

A
  1. lame leg has a decreased stance (weight-bearing) phase - quicker, short steps
  2. drags toe because the leg is left out behind
  3. increased lameness when limb is on the outside of the circle

joint effusion (femoropatellar pouch) + hind end muscle atrophy (chronic)

50
Q

How is stifle lameness diagnosed?

A
  • positive on upper limb flexion and caudal extension
  • blocks to joint
  • radiographs
  • ultrasound
  • arthroscopy
  • nuclear scintigraphy
51
Q

What 3 breeds most commonly develop stifle osteochondrosis? What 2 lesions are most commonly seen?

A

WB, TB, QH

  1. trochlear ridge OCD
  2. medial femoral cysts
52
Q

What are the 2 most common signs of stifle OC? What treatment is recommended?

A
  1. effusion
  2. lameness when training starts

surgery once horse reaches 1 y/o –> debride and fill cysts with biologics, scaffolds, corticosteroids, or screws

53
Q

What is prognosis of stifle OC like?

A

depends on severity and success of surgery –> typically leads to OA

54
Q

What are 3 etiologies of stifle OA? How is it diagnosed?

A
  1. underlying OC
  2. trauma
  3. athletic use

blocks to stifle

55
Q

What treatment is recommended for stifle OA? What is prognosis like?

A

intra-articular corticosteroids

fair - high motion, complicated joint

56
Q

What is upward fixation of the patella? What causes it?

A

medial patellar ligament is caught over the medial trochlear ridge when the stifle extends

inability to release stay apparatus and quadriceps are unable to contract and disengage patella from the medial trochlea–> in a normal horse, the quadriceps contract and pull the patella up and the MPL slides it down

57
Q

What are 2 possible etiologies of upward fixation of the patella?

A
  1. weak quadriceps
  2. conformation - straight legs
58
Q

How do severe and mild cases of upward fixation of the patella present?

A

SEVERE - stifle is locked in extension and left behind

MILD - horse catches their stifle

59
Q

What are 2 non-surgical treatments for upward fixation of the patella?

A
  1. immediate - back horse up to release the patella
  2. exercise to strengthen quadriceps - hills, Cavaletti poles
60
Q

What are 2 options for surgical treatment of upward fixation of the patella?

A
  1. medial or middle patellar ligament splitting/blistering - dextrose injected to strengthen ligament
  2. medial patellar ligament desmotomy - last resort, releasing ligament can affect stifle stability and fragment distal patella

Large Animal Surgery (32 decks)

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