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VMS4008 - EQUINE > Lameness in the Equine Athlete > Flashcards

Lameness in the Equine Athlete Flashcards

(64 cards)

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1
Q

What main 3 types of athletes ?

A

Showjumper
Dressage Horse
Eventer

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2
Q

what mechanics in showjumping ?

A

More weight in HQs
- Brought forward and under the rider during locomotion
- Rq for engagement, collection & takeoff
- Inc stress of joint and ST

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3
Q

Stress on forelimbs inc during take off and landing?

A
  • Considerable impact on landing
  • Holds entire weight of H & R
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4
Q

Surfaces for showjumping?

A
  • soft deep surfaces r MORE EFFORT
  • Early fatigue of ST
  • Hard surfaces may result in bone and joint related injury, distal limb foot problems
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5
Q

Studs use in showjumper?

A
  • Placed to enhance traction - lat +/- medial
  • Creates mediolat imbalance
  • If ground hard - dorsopalmer balance altered
  • Concentrates force -> deep bruising
  • Stud girth -> protection
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6
Q

what are the main lameness issues of Showjumpers?

A
  1. Foot pain
  2. Distal hock joint pain
  3. Thoracolumbar region pain
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7
Q

Describe ‘Foot sore’ ?

A
  • Approx. 60% of bodyweight on forelimbs
  • Impact on landing greatly increases load and structural stresses on structures
    within hoof capsule
  • Shoeing very important
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8
Q

Cause fo Foot Sore?

A
  • Subsolar bruising
  • Subsolar abscess
  • Sheared heels
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9
Q

DIP Joint synovitis & osteoarthritis ?

A

Coffin joint OA - Frequently bilateral
+/- joint effusion

Forelimbs most commonly affected

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10
Q

Diagnostics for DIP synovitis/ OA?

A
  • Radiographic changes may be absent or subtle periarticular osteophytes or enthesophytes
  • US of the collateral lig of the DIP joint should be performed
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11
Q

What should we do for horses unresponsive to tx of DIP synovitis/OA ?

A

Evaluate for soft tissue damage within the foot

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12
Q

How do we evaluate collateral ligament injjury of the DIP?

A
  • Medial and LAteral
  • US may show disruption or enlargement
  • MRI-gold standard in imaging
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13
Q

Tx for collateral injury of DIP?

A

– Corrective shoeing and prolonged rest
– Followed by a prolonged walking programme
– Shock wave or laser therapy

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14
Q

What to do if unresponsive to conservative tx for collateral DIP joint?

A

Palmar digital neurectomy?

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15
Q

Describe Navicular Syndrome

A
  • Slow insidious onset
  • early signs -> shortenign of stride, tripping or stumbling
  • Presents as a unilat lameness but condition usually bilat
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16
Q

How can we diagnose navicular syndrome?

A
  • Hoof testers
  • Wedge test may accentuate lameness
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17
Q

What range of conditions does navicular syndrome incompass?

A

o Navicular Bone Pathology
o Navicular Bursitis
o Navicular suspensory desmitis ( collateral sesamoidean ligament)
o Impar Desmitis
o DDFT injury/tear or Adhesions of the DDFT

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18
Q

Radiography of Navicular Bone?

A
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19
Q

Pathology fo the navicular bone on radiography?

A
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20
Q

What is the most common hind limb lameness ?

A

Distal Tarsal OA

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21
Q

Distal Tarsal OA is usually due to which joints of the tarsus?

A

Tarsometatarsal (BLUE) and Distyal intertarsal joint (RED)

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22
Q

What can result in Distal tarsal OA?

A
  • conformational defects
  • developmental abnormalities
  • torsional stresses placed on distal hock joints
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23
Q

Tarsal Oa often seen in combination with …?

A

lumbar pain & SUSPENSORY DESMITIS

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24
Q

Diagnosis of Distal Tarsal OA?

A

Hindlimb lameness - worse with limb on inside of circle and on hard ground
Positive to hindlimb flexion test
Positive to tarsometatarsal joint block
Radiographs

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25
What radiographic changes with u see with distal tarsal OA?
varies: none-> severe (joint fusion) (changes don't correlate with ° of lameness) o Periarticular osteophytes/enthesophytes o Joint space irregularities/narrowing o Subchondral bone sclerosis o Fusion of joint space
26
What often occurs 2ary to hindlimb lameness?
Back pain -> always perform lameness assessment as part of investigation og back pain
27
Most common causes of back pain?
- Muscular soreness / strain - Impinging dorsal spinous processes - Sacroilliac Pain
28
What are some less common back pain causes?
- Facet joint OA - discospondylitis
29
How do we diagnose kissing spiness( impingement of dorsal spinous processes)
Back palpation Radiography nuclear scintigraphy (inc uptake) Diagnostic analgesia
30
What can u see on radiography with kissing spines?
-impingement/overriding → narrowed/no space between dorsal spinous processes -sclerosis →increased bone opacity -periosteal reaction →new bone formation -Cyst formation →radiolucent defects
31
Describe conservative tx for kissing spine?
- SADDLE FITTING!! - NSaids - Medicate back -> Steroids +/- Mesotherapy - Biphosphonates - Other -> acupuncture; rehab
32
What Surgical tx for kissing spines?
- Interspinous Ligament Desmotomy - Dorsal Spinous Process Resection or Subtotal Osteotomy
33
Aetiologies for Sacroiliac Joint pain?
- Oa - Desmitis - dorsal sacroiliac lig - Chronic joint instability - Acute subluxation
34
what presentation of sacroiliac pain?
Poor performance Refusal at jumps Reduced hindlimb propulsion Back soreness
35
Diagnosis fo sacroiliac pain?
– Clinical Examination – Ultrasonography – Scintigraphy – Intra-articular/periarticular diagnostic analgesia Often diagnosed by exclusion/positive response to treatment
36
Tx for sacroiliac pain?
- Intra-articular steroid injections - Rest - controlled exercised plan
37
Dressage horse - what issues why?
- Requires balance, suppleness and hind limb activity - Centre of gravity is placed further caudally increasing degree of flexion and loading on hindlimbs - Lateral movements apply specific unique strains to different structures within skeleton - Training surfaces- artificial surface with a high degree of cushioning →consistent surface
38
What are the most common issues in dressage?
1. Proximal suspensory desmitis (HL >FL) 2. suspensory branch lesions 3. Desmitis of the forelimb accessory ligament of the deep digital flexor tendon
39
Describe Proximal Suspensory Desmitis?
- More common in the hind limbs - Commonly bilat this may delay diagnosis - Repetitive strain injury
40
Diagnosis of Proximal sensory desmitis?
- Lameness -> worse on soft ground & affected leg worse on outside of circle - Palpation - difficult due to deep location - Diagnostic analgesia -> +ve to deep branch of lateral plantar nerve block & -vs to TMT block initially
41
Proximal sensory desmitis on US?
enlargement, fibre disruptionareas of reduced echogenicity changes can be very subtle always US both
42
Proximal suspensory desmitis on Xray?
Proximal metatarsal region irregularities in proximal planter cortex Endosteal new bone
43
What other diagnostics might we do with proximal suspensory desmitis ?
Scintigraphy and MI
44
Tx for Proximal suspensory desmitis?
- Rest - Rehab - ACSWT - Medication of tarsometatarsal joint with corticosteroid - Core lesion -> intralesional injection with platelet rich plasma or stem cells
45
What surgical tx options for proximal suspensory desmitis?
- Neurectomy - deep branch of lateral plantar nerve - Fasciotomy
46
Suspensory Branch Desmitis if often acute onset and accompnied by ....?
– Peri-ligamentous swelling – Enlargement of ligament – Often painful on palpation
47
Diagnosis of suspensory branch desmitis?
-> US -enlargement of Branch - Periligamentous fibrosis - +/- core lesion -> Radiography - sesamoid bones - may show enthesopathy, sesamoiditis & fragmentation
48
Tx for suspensory branch desmitis?
- Prolonged rest (4-6m) - Shockwave therapy - Controlled exercise 3-4 months - Intralesional tx if core lesion present
49
Predisposing factors to correct in suspensory branch desmsitis?
- Mediolateral imbalance in feet - Limb deviations
50
What is Desmitis of the Accessory Lig of DDFT (Check lig Desmitis)
- Acute injury-sudden onset lameness - Heat pain swelling of proximal third of metacarpal region - Cause -> overextension of the carpus
51
Diagnosis of Chekc lig desmitis?
US - Enlargement - Loss of definition of the margins - Ares of reduced echogenicity
52
Tx of Desmitis of accessory lig ?
- controlled ascending walking programme better than complete box rest - 3-6 months - Risk of recurrence -Good results with tx with intralesional PRP
53
What cross country injuries prone?
- Soft tissue - OA also common - Acute traumatic injuries
54
What. is super important. inthese Three day eventing horses?
conformation!n
55
Main issue in three day event horse?
Superficial digital flexor tendonitis
56
why do we tend to see this?
* Most commonly occurs from cyclical repetitive loading * But can occur from a single-event injury ie fall or stumble Tendons prone to development of accumulated microdamage during intense training →Slight filling & heat in palmer metacarpal region
57
How do CLs develop with superficial digital flexor tendonitis?
Clinical signs of SDFT strain then develop acutely after training or competition OR may be subclinical following competition but become evident when training resumes
58
How should we be monitoring these horses?
Ultrasound!!
59
What happens with Annular Ligament Syndrome?
thickening of the palmar or plantar annular ligament (PAL)
60
Who commonly gets ALS?
heavy breeds/warmblood and horse with foot pathology
61
Describe primary vs secondary ALS
-> Primary ALS * Pathology of PAL itself * Hypoechoic areas within the PAL -> Secondary ALS * Pathology of surrounding soft tissue structures * Digital tendon sheath * Flexor tendons
62
What is manica flexoria?
* A band-like structure of the SDFT that wraps around the DDFT just above the fetlock * Most commonly injuries occur in hindlimbs
63
Who is more susceptible to manica flexoria?
cob-types and ponies
64
Dx. &tx of manica flexoria
Diagnosis * Digital flexor tendon sheath block * U/S * Contrast Study Treatment * Surgical resection -> Tenoscopy & resection

VMS4008 - EQUINE (30 decks)

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