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Foal/Juvenile Lameness Flashcards

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1
Q

Distal radius growth plate closure times

A

24 months

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2
Q

Distal metacarpal growth plate closure time

A

6-9 months

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3
Q

Proximal phalanx growth plate closure time

A

6-12 months

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4
Q

Distal tibia growth plate closure time

A

17-24 months

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5
Q

Distal tibia growth plate closure time

A

9-12 months

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6
Q

Inflammation of the physis or growth complex at the end of a long bone

A

Physitis

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7
Q

Is physis active in young or old animals?

A

Young

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8
Q

When can physitis occur?

A

Until closure of growth plates

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9
Q

When does long bone growth occur?

A

Most of the long bone growth happens when the foals are resting rather than loadbearing

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10
Q

Until what age is the growth phase of the distal metacarpus?

A

4 months

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11
Q

Until what age is the growth phase of the distal radius and distal tibia?

A

18-20 months

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12
Q

Clinical signs of physitis

A

Heat
Pain on palpation
Possibly lameness

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13
Q

Joints most commonly affected by physitis

A

Carpus
Fetlock

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14
Q

Triggers of physitis

A

Sudden increase in feed intake or feed energy
Abrupt increase in exercise regimen
Direct trauma to the physis
Yearling physitis (often distal radius)

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15
Q

Diagnosis of physitis

A

Radiograph (soft tissue swelling and remodelling)

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16
Q

Treatment of physitis

A

Exercise restriction
Pain relief
Correction of underlying cause (angular limb deformity)
Sepsis?

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17
Q

Does physitis always cause lameness?

A

No, but will be lame if septic

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18
Q

Which type of Salter-Harris fracture is most frequent in foals?

A

Type II

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19
Q

Treatment options for Salter Harris fracture

A

Cast coaptation (<6 weeks)
Surgical correction (image shows transphyseal bridge)

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20
Q

Where do Salter-Harris fractures occur in foals?

A

Distal physis of MCIII/MTIII

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21
Q

Does this carpus show normal or abnormal ossification in a foal?

A

Normal

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22
Q

Bones affected by incomplete ossification in foals

A

Cuboidal bones (carpi, tarsi)

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23
Q

When does ossification occur during gestation?

A

Last 2-3 months of gestation (premature or dysmature foals should be radiographed to assess ossification)

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24
Q

Is this ossification in a foal carpi normal or abnormal?

A

Abnormal (incomplete ossification)

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25
Is this ossification in a foal carpi normal or abnormal?
Abnormal (incomplete ossification)
26
Is this ossification in a foal tarsi normal or abnormal?
Abnormal (incomplete ossification)
27
Is this ossification in a foal tarsi normal or abnormal?
Abnormal (incomplete ossification)
28
Management for incomplete ossification in foals
Box rest until bones completely developed
29
What is shown in this image?
Angular limb deformity of carpi (valgus)
30
What is shown in this image?
Flexural limb deformity
31
What condition is this?
Windswept foal (black arrow: varus, white arrow: valgus)
32
Causes of incomplete ossification
Dysmature foal Premature foal Placentitis during gestation Mare colic during gestation or heavy parasite burden (uterine lack of blood supply) Abnormal uterine positioning
33
Aetiologies of angular limb deformities
Incomplete ossification Peri-articular laxity Acquired or congenital
34
Evaluation of angular limb deformities
Static (stand perpendicular to frontal plane of limb, not foal) Dynamic Manipulation (peri-articular laxity) Radiography (orthogonal views, both limbs)
35
Can you treat angular limb deformities when peri-articular laxity is present?
No, monitor for loss of laxity before doing any interventions
36
Conservative treatment of angular limb deformity when there is normal ossification and peri-articular laxity
Box rest and controlled exercise
37
Conservative treatment of angular limb deformity when there is incomplete ossification
Box rest
38
When is conservative treatment of angular limb deformity acceptable?
Entire limb facing one way
39
How should you trim/rasp the foot with carpal valgus?
Trim lateral hoof wall
40
How should you trim/rasp the hoof foot with fetlock varus
Medial hoof wall
41
Where should a glue on shoe extension be placed with a carpal valgus?
Medial extension
42
Where should a glue on shoe/extension be on a foal with fetlock varus?
Lateral
43
When is surgical treatment indicated for angular limb deformity?
No response to treatment One joint facing in a different direction that the one above/below Persistent ulna/fibula Age
44
What condition is shown in this radiograph?
Persistent ulna (most commonly mini horses)
45
What age should surgical intervention be considered for angular limb deformity?
When growth has stopped/growth plates have closed
46
How does this surgical intervention manage an angular limb deformity?
Stop growth on the lateral side
47
At what age do horses suffer from juvenile osteochondral conditions
First 2 years of life
48
What are the 5 juvenile osteochondral conditions?
Ligament associated OCF Peri-articular osteocondylar fragmentation/OCF (including OCD) Subchondral bone cyst Osteochondral collapse Physitis
49
Clinical signs of juvenile osteochondral conditions
Often silent Joint effusion? Lameness?
50
Main focus in lameness examination when investigating juvenile osteochondral conditions
Reaction to flexion tests
51
Which joints in young horses are more commonly associated with lameness/higher levels of lameness?
Stifle and shoulder
52
Causes of osteochondrosis
Multifactorial Focal failure of endochondral ossification (epiphyseal or metaphyseal growth cartilage) Polygenetic heritable disease
53
Origin of osteochondral fragmentation in fetlock that is always caused by OCD
Sagittal ridge of MCIII/MTIII
54
Best view to look for fragmentation due to osteochondrosis dissecans in fetlock on sagittal ridge
Flexed
55
What is this radiograph showing?
Radiolucency is a fragment on sagital ridge or MCIII (always caused by OCD)
56
Fragments in the fetlock with an unclear origin (may be caused by/mistaken for OCD)
Palmar/plantar P1 fragment (arrow, usually avulsion fragmentation by distal and oblique sesamoid ligaments) Dorsal margin of proximal P1 (trauma)
57
Types of fragmentation in fetlock joint and their common causes
Sagittal ridge (OCD) Palmar/plantar P1 (avulsion, black circles) Dorsal margin of proximal P1 (trauma, white circles)
58
Age dependent top differential of subchondral lucencies on radiograph
<2y, OCD >2y, trauma-induced
59
Diagnosis of OCD
Lameness examination 4 orthogonal views (Fragments? Soft tissue swelling?)
60
Challenges with diagnosis of tarsus OCD
Many foals have lesions at 1 month then many heal by 1 year (healing potential better in distal aspect trochlear ridge) (Few lesions originate/resolve after age of 5 months)
61
Challenges related to diagnosis of stifle OCD
Very dynamic process
62
2 treatment options (dependent on clinical signs)
Leave it Remove (usually GA, occasionally standing sedation)
63
Considerations when making treatment recommendations
Intended purpose of horse (high speed = remove all) Ownership (Future sale? Genomic breeding value?) Finance, risks (GA) and prognosis
64
Typical treatment recommendation for loose fragments in joint
Removal
65
Typical treatment recommendation for osteochondrosis flattening in joint
Monitor and see
66
When does osceochondrosis become osteochondrosis dissecans?
When pathology progresses from flattening to osteochondral fragmentation
67
What does this radiograph show?
Palmar P1 defect, most likely due to cartilage so not visible on radiograph
68
Aetiology that could cause palmar P1 defect (controversial)
Osteochondrosis Trauma
69
Aetiology of fragment of dorsoproximal P1 fragment in racehorses
Trauma from overextension of fetlock at high speed in racehorses (Unclear in non racehorses)
70
Most common presenting complaint in osteochondral conditions
Joint effusion
71
What is 1 on this tarsus?
Distal intermediate ridge of tibia (DIRT lesion) DMPLO view
72
What is 2 on this tarsus?
Lateral trochlear ridge of talus DMPLO view
73
What is 3 on this tarsus?
Medial malleolous of the tibia (concern with OCD is intra-articular aspect)
74
Top 3 sites for hock OCD
Distal intermediate ridge of tibia (DIRT) Lateral trochlear ridge of talus Medial malleolus of the tibia (intra-articular aspect)
75
What is this site of osteochondrosis in the fetlock?
Sagittal ridge of distal metacarpal
76
Main site of OCD lesions in stifle joint
Lateral trochlear ridge of femur (lateral trochlear ridge is shorter than the medial trochlear ridge)
77
Which anatomical structure contains a cyst like structure on this radiograph?
Medial femoral condyle
78
What does this image show? (2 year old)
Effusion of femoropatellar joint
79
Fetlock radiograph views for OCD
DP LM +/- Flex lateral DMPLO DLPMO
80
Where is the fragment in this DMPLO view of the fetlock?
Palmaro/plantaromedial
81
Special view to look for palmar/plantar fragmentation in fetlock
Dorsal 30 proximal 70 lateral-palmarodistal medial oblique
82
View to look for tarsus fragmentation
DP* (dorsal 15 degree lateral-plantarmedial oblique) LM DMPLO* (5 degrees disto-proximal) DLPMO
83
Stifle radiograph views to diagnose OCD
Lateromedial Caudocranial Caudo(60)lateral-craniomedial oblique
84
Which structure for OCD diagnosis is highlighted in the stifle caudocranial view?
Femoral condyles
85
Which structure for OCD diagnosis is highlighted in the stifle caudolateral-craniomedial view?
Femoral condyles Lateral trochlear ridge
86
Conservative management options for osteochondrosis
Box rest/small paddock Joint injection with corticosteroids
87
What condition might a horse suffer from if fragments are not removed in the tarsus and stifle?
Osteochondrosis
88
Clinical signs of subchondral cyst-like/SCL lesions
Lameness (more likely than in OCD) Joint effusion Positive response to flexion
89
Bone containing subchondral lucency in E
P2
90
Bone containing subchondral lucency in G
P1
91
Aetiologies of sub-chondral cyst like lesions
Osteochondrosis Trauma to articular cartilage/subchondral bone
92
Most common sites of subchondral cyst-like lesions (there are many)
Medial femoral condyle Phalanges Metacarpus/metatarsus Radius Scapula Tibia Carpal bones Cervical vertebrae
93
Most 'telling' diagnostic sign during lameness examination of subchondral cyst-like lesions
Improvement with joint block
94
Treatment options for subchondral cystic lesions
Intra-lesional injection with corticosteroids (SCL which communicate with joint, arthroscopic guidance) Mesenchymal stem cells within joint (no arthroscopy, under GA with ultrasound guidance) Arthroscopic debridement (remove unsupported cartilage) Transcondylar bone screw (GA, standard cortical screw or absorbable screw) Conservative (acceptable if no lameness, needs monitoring)

Equine (Poppy) (11 decks)

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