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MSK Flashcards

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1
Q

joints affected by bog spavin

A

distal IT and TMT joints

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2
Q

aetiology of bog spavin

A

concussion and shear forces/stress on hock joints

  • common in jumpers, western pleasure, STBs
  • conformation predisposition
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3
Q

CS of bog spavin

A
  • mild HL lameness, freq. bilateral
  • reduce performance
  • breaking on turns
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4
Q

rad signs of bone spavin

A

osteophytes + enthesiophytes + sclerosis + lysis + joint narrowing

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5
Q

bog spavin conservative tx

A
  • corrective shoeing
  • intra-articular corticosteroids +/- HA
  • systemic NSAIDs, PSGAG, HA, Epitalis
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6
Q

sx tx of bog spavin

A

arthrodesis of distal hock joints

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7
Q

sites of OCD in the tarsus

A
  1. Distal intermediate ridge of the tibia
  2. Lateral trochlear ridge of talus
  3. Medial malleolus
  4. Medial trochlear ridge of talus
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8
Q

OCD of tarsus prognosis

A

good to excellent w/ athroscopic sx

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9
Q

ddx of capped hock

A
  • gastrocnemius bursitis
  • calcaneal bursitis
  • DDFT sheath effusion
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10
Q

tx of capped hock

A
  • stop inciting cause
  • drain bursa + inject w/ corticosteroids
  • topical and systemic AI + pressure bandage
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11
Q

define thoroughpin

A

= tenosynovitis of the tarsal sheath (flexor tendon sheath of DDFT)

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12
Q

CS of thoroughpin

A
  • swelling lateral and medial to common calcaneal tendon and proximal to tuber calcis
  • most are not lame
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13
Q

tx of thoroughpin

A
  • drainage
  • intra-tendinous corticosteroids and/or HA (acts as antiinflm + reduces adhesion to tendon sheath)
  • often recurs
  • tenoscopy and lavage + ABs if infected
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14
Q

what is curb?

A

soft tissue swelling of plantar aspect of tarsus

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15
Q

CS of curb

A
  • convex appearance to plantar aspect calcaneous

- acute lameness w/ pain on palpation

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16
Q

US findings of curb

A
  • desmitis of long plantar ligament
  • tendonitis SDFT
    OR inflam/thickening of soft tissue at back of tarsus
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17
Q

tx and px of curb

A
  1. Rest
  2. Topical and systemic AIs
  3. Inject area w/ corticosteroids (US guided)
  4. Freeze firing de-innervates the c-fibres which provide pain sensation in area

Mostly good px but can recur.
Guarded for STBs - tend to chronically re-injure area

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18
Q

tarsal fracture characteristics

A
  1. most are slab fxs
  2. Can be managed conservatively or Lag screw fixation w/ CT
  3. Prognosis fair/good but will develop OA in joint if conservative tx only
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19
Q

tx of tibial stress fxs

A
  • stall rest for up to 6months
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20
Q

diagnosis of tibial stress fractures

A
  1. CS: mostly TBs in training, acute onset HL lameness w/ no other signs
  2. Blocks are inconclusive
  3. Rads - some changes if chronic
  4. Nuclear scintigraphy/bone scan = definitive diagnosis
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21
Q

CS of upward fixation of the patella

A
  1. Medial patella lig locks over medial femoral condyle –> HL locked in extension, toe drags
  2. Usu intermittent - may mimic stringhalt
  3. When they release the stifle often exaggerated flexion of the hock
  4. Typically worse in the morning - horse cold/not warmed up
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22
Q

Tx of upward fixation of the patella

A
  1. Exercise program: trot work and deep sand/hill work
  2. Oestrogen supplementation supposed to relax ligaments - wkly injection of oestradiol
  3. Counter- irritants over medial patella ligament
  4. Surgery: Medial patella desmoplasty - stab incision into medial patella ligament
    Last resort = medial patella desmotomy
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23
Q

tx and px of cranial cruciate ligament rupture

A
  • rest + AI

- guarded px

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24
Q

characteristic gait of fibrotic myopathy of the semitendinosus/semimembranosus muscles

A

foot rapidly snatch down during anterior phase

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25
signalment of fibrotic myopathy
QH, polo, cutting, roping horses | --> tearing of flexor muscles
26
tx of acute fibrotic myopathy
AI, rest, physio, intra-lesional cortisone
27
causes of peroneus tertius rupture
- overextension of the hock - direct trauma - avulsion fractures in foals
28
dx of peroneus tertius rupture
simultaneous flexion of stifle and extension of hock
29
tx of peroneus tertius rupture
rest, AI (local + systemic NSAIDs) + controlled exercise program after 6wks
30
treatment of pelvic fxs
stall rest 4-6months + re-evaluate
31
tx of proximal femoral physis fracture in foals
internal fixation - lag screws/ 135 dynamic hip screw
32
treatment of craniodorsal coxofemoral luxation
- closed reduce under GA - open reduction w/ joint imbrication, screw and wire fixation or translocation of greater trochanter - femoral head ostectomy for <200kg
33
CS of sacroiliac subluxation
- reduced performance, lameness acutely | - muscle spasm and pain on palpation
34
tx of sacroiliac subluxation
inject w/ cortisone or counter-irritant + rest 3m
35
what CS is diagnostic for sacroiliac subluxation?
"hunter's bump" | - asymmetry of rump either side of spine
36
what is high vs. low ringbone?
OA of interphalangeal joints high = proximal IP jt low = distal IP jt
37
what conformational faults predispose to ringbone?
1. Toe-in or Toe-out: sloping coronet + jt imbalance 2. Uneven wear on distal joints + hoof wall 3. Offset pastern: abnormal breakover 4. Abnormal stresses on lower joints
38
high ring bone blocks to..
abaxial sesamoid nerve block
39
management of ring bone
1. Intra-articular medications - corticosteroids - HA - IRAP (interleukin-1 receptor antagonist protein) - Arthramid 2. Corrective shoeing: balance foot, roll the toe 3. Pain meds: PSGAGs + NSAIDs (bute/melox)
40
sx tx of ring bone
1. Pastern joint arthrodesis | fair prognosis HL> FL
41
treatment of palmar/plantar eminence fractures of P2
- lag screw fixation + cast OR - arthrodesis
42
pastern subluxation causes disruption of what soft tissue structures?
- SDFT and collateral ligs | - distal sesamoid ligs
43
tx of pastern subluxation
pastern arthrodesis
44
arthrodesis technique for comminuted fxs OR palmar/plantar instability of pastern
= double plate fixation
45
indications for a transfixation cast
- severely comminuted fxs | - open fxs
46
treatment of pastern OCD
- intra-articular medication - bute - rest --> will develop OA (if severe OA arthrodesis) OR transcondylar screw across cyst
47
name the 6 different types of sesamoid fxs
1. Apical 2. Mid-body 3. Basal 4. Abaxial 5. Sagittal 6. Comminuted
48
why do proximal sesamoid fxs occur?
- high speed exercise + hyperextension of the fetlock | - trauma
49
Diagnosis of proximal sesamoid fx by rads. What else do you need to know for prognosis?
need to check for concurrent SL damage via ultrasound
50
which is the most common type of sesamoid fx?
apical sesamoid bone fx
51
what causes abaxial sesamoid fractures?
avulsion fractures at the SL insertion point in racehorses
52
why is surgery not indicated in abaxial sesamoid fxs?
could cause disruption of the suspensory lig
53
what forces cause mid-body sesamoid fractures?
the bone is pulled in two directions by the suspensory and the sesamoidean ligs --> bone fails
54
prognosis for basilar sesamoid fxs?
guarded - depends on fragment size | - loss of integrity w/ sesamoidean ligs
55
tx principles of sesamoid articular fxs
- remove fragments up to 1/3 size of bone OR - lag screw larger fragments + cast
56
why are sesamoid fxs notoriously poor healers?
- poor blood supply - tension - movement
57
discuss prognosis for different types of sesamoid fxs
Good for apical + abaxial | Guarded for Basilar, midbody, axial + comminuted
58
rad findings assoc w/ sesamoiditis
increased size and number of vascular channels
59
two manifestations of fetlock OCD
- OCD of sagittal ridge of distal MC III | - subchondral cystic lesions of distal cannon bone
60
treatment of sagittal ridge lesions
1. Type 1: no tx if incidental - allow horse to mature | 2. Types II and III - arthroscopic removal
61
tx of cystic lesions in fetlock
- lag screw across cyst | - IA corticosteroids
62
common site of chip fractures of the fetlock joint
medial dorso-proximal eminence P1
63
why are HL P1 fxs more commonly spiral/larger fxs than FLs?
HL = greater torsion forces
64
P1 short complete fx tx
- stall rest if <10mm | - lag screw
65
lameness assoc. w/ P1 long incomplete fxs
4/5 grade lameness
66
tx of complete sagittal fxs of P1
- internal fixation w/ lag screws
67
difference between Type 1 and Type 2 proximal palmar/plantar P1 fragments
Type 1 = articular | Type 2 = non-articular
68
cause of palmar/planter OC disease of MC/MT III
- heavy/premature training of immature skeleton --> repetitive hyperextension = microfractures -- cartilage damage --> bone necrosis + lysis - common in 3-4yo TBs in training - flattening of palmar condyle(s) of MC III --> impact pt during gallop
69
px of POD of MC/MT III
guarded in severe cases | prevention and rest is key
70
what's a hygroma?
fluid filled swelling over the dorsal aspect of the carpus
71
hygroma ddx
synovial hernia
72
hygroma tx
- needle drainage - inject corticosteroids 2-3x - pressure bandage for >14days or will come back
73
common sites of carpal chip fractures
- distal lateral radius (RC joint) - distal radiocarpal bone (MC jt) - proximal C3 (MC jt)
74
why do carpal slab fractures most commonly occur in C3?
the biggest bone and susceptible to a lot of load
75
lameness assoc. w/ C3 slab fx?
grade 4-5/5 - hobble
76
C3 slab fractures are best seen with what rad view?
skyline of carpus
77
tx and px of accessory carpal bone fx
- support and stabilise carpus (splints + lots of bandage) - rest for 4-6m - fair to good prognosis
78
recommended physio of in tx carpal fxs?
flex carpus 20-30x daily to prevent fibrosis of the joint
79
prognosis of carpal fxs
- rel to amount of cartilage damage and OA present - depends jt involved: radiocarpal > midcarpal - gen. good to very good
80
what is third carpal bone disease?
starts w/ subchondral lysis as a respone to remodelling because of the load being placed on it then secondarily hardens --> sclerosis Bone hardness prediposes to subchondral plate failure + chip/slab fxs
81
tx of third capal bone disease
1. rest usu 6-12wks, up to 6m 2. athroscope: can debride to encourage healing (but rare) 3. IA and systemic chondroprotective agents IRAP, pentosan
82
px of third carpal bone disease
given lack of successful tx --> guarded to fair
83
likely outcomes for radial fxs
- euthanasia | - double plate internal fixation if <250kg
84
CS for ulnar fractures
- loss of tricep mm function - dropped elbow - swelling around joint
85
benefits of splint stabilisation for a non-displaced fx
1. restores limb support 2. prevents contracture 3. protects contralateral limb
86
match the ulnar fx type w/ plate fixation method
1. Type 1 + 2 = curved plate for apophyseal fxs | 2. Types 3-6 = tension band plate
87
tx of olecranon bursitis
- NSAIDs - needle drainage + intralesional corticosteroids - surgical drainage OR en bloc resection ++ nullify inciting cause: soft/deep bedding or bell boots/pastern rings
88
two types of humeral fxs
1. Acute severe trauma --> complete fx | 2. Stress fxs --> incomplete
89
how does size effect humeral fx prognosis
1. if <200kg: double plate fixation + IM interlocking nail + IM pins 2. If >200kg - stall rest if incomplete or euthanasia if complete
90
CS of radial nerve paralysis
- unable to extend carpus or advance limb | - dropped elbow, drags limb, marked head movement
91
prognosis of scapular supraglenoid tubercle avulsion fracture
- if small articular component can remove - lag screw and tension band wire fair prognosis, OA may develop
92
prognosis of spine/body scapula fxs
- poor | - high risk of implant failure w/ such thin bone
93
what cause sweeny?
- should trauma - stretch from caudal slippage of limb - damage to brachial plexus --> causes suprascapular nerve damage --> atrophy of infraspinatus and supraspinatus muscles
94
conservative vs. sx tx of sweeny?
1. Stall rest for up to90d --> spont recovery | 2. Surgery --> release nerve from entrapping fibrous tissue +/- conservative notching of scapula (fx risk)
95
classification of condylar fractures
1. fx configuration: complete/incomplete | 2. location: displaced/non-displaced, lateral/medial
96
Lateral condylar fractures tx options
1. Prior to sx limb stabilisation + analgesia + IVFT 2. Incomplete/non-displaced = lag screw fixation 3. Complete = lag screw fixation +/- open reduction
97
tx of medial condylar fractures
- open reduction, lag scre fixation and neutral plate | - standing lag screw fixation via stab incisions
98
radiographic diagnosis of shin soreness
- periosteal new bone over dorsal cortex of MCIII - thickened dorsal cortex - radiolucent lines in dorsal cortex - unicortical oblique fracture(s) in dorsal cortex = saucer fx
99
is high speed work okay for shin soreness?
yes - but shorter workouts + less often is req.
100
tx of shin soreness
Rest 60-90d AI +/- Freezing firing, Percutaneous periosteal scraping, ESWT
101
tx options for stress fxs
1. Osteostixis | 2. Unicortical screw
102
what is 'splints'?
bony exostosis of the 2nd or 4th MC/MT bones
103
clinical significance of distal splint bone fxs?
- assess suspensory lig involvement via US | - often left and reform themselves
104
compare tx of proximal splint bone fxs on the medial vs. lateral splint bone
Medial splint bone - remove up to 1/3 prox + implants | Lateral splint bone is more forgiving --> conservative/internal fixation or complete removal

Equine (7 decks)

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