首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献，搜索用时 437 毫秒
1.
Radiographic contrast studies were used in 50 forelimbs from 13 live horses and 12 fresh adult cadavers to determine the frequency of communication between the navicular bursa and the distal interphalangeal joint. Injections of contrast medium were made into the dorsal aspect of the distal interphalangeal joint of one limb and into the navicular bursa of the other forelimb of each horse. In 25 limbs in which contrast medium was injected into the distal interphalangeal joint, no communication was demonstrated between the joint and the navicular bursa. In 20 of the 25 limbs in which injection was made into the navicular bursa, no communication between joint and bursa was seen. In five horses, contrast medium was visible in both the distal interphalangeal joint and the navicular bursa. However, in four of five horses the communication was clearly iatrogenic. In both limbs of one horse, contrast medium was seen to enter the digital flexor tendon sheath after injection into the navicular bursa.
There is probably no naturally occurring communication between the navicular bursa and distal interphalangeal joint in the horse.  相似文献   

2.
Foot pain is an important cause of lameness in horses. When horses with foot pain have no detectable radiographic abnormalities, soft‐tissue assessment remains a diagnostic challenge without magnetic resonance (MR) imaging. Ultrasonography can provide an alternative to MR imaging when that modality is not available but the extent of changes that might be seen has not been characterized. We reviewed the ultrasonographic findings in 39 horses with lameness responding positively to anesthesia of the palmar digital nerves and without radiographically detectable osseous abnormalities. Thirty of the 39 horses had lesions affecting the deep digital flexor tendon (DDFT), 27 had abnormalities in the distal interphalangeal joint of which six had a visible abnormality in the collateral ligament. Ultrasonographic abnormalities were seen in the podotrochlear bursa in 22 horses and in the ligaments of the navicular bone in two horses. Abnormalities of the navicular bone flexor surface were detected in eight horses. In three of the 39 horses, only the DDFT was affected. The other 36 horses had ultrasonographic abnormalities in more than one anatomical structure. Based on our results, ultrasonographic examination provides useful diagnostic information in horses without radiographic changes.  相似文献   

3.
Abnormalities of the deep digital flexor tendon, navicular bone, and collateral sesamoidean ligament can be difficult to visualize using magnetic resonance imaging (MRI) if bursal fluid is absent. The use of saline podotrochlear bursography improves podotrochlear apparatus evaluation, however, the technique has disadvantages. The objective of this prospective feasibility study was to describe saline arthrography of the distal interphalangeal joint as an alternative technique for improving MRI visualization of the deep digital flexor tendon, navicular bone, collateral sesamoidean ligament, and podotrochlear bursa, and to compare this technique with saline podotrochlear bursography. Eight paired cadaver forelimbs were sampled. Saline podotrochlear bursography or saline arthrography techniques were randomly assigned to one limb, with the alternate technique performed on the contralateral limb. For precontrast and postcontrast studies using each technique, independent observers scored visualization of the dorsal aspect of the deep digital flexor tendon, palmar aspect of the navicular bone, collateral sesamoidean ligament, and podotrochlear bursa. Both contrast techniques improved visualization of structures over precontrast MR images and visualization scores for both techniques were similar. Findings from this study demonstrated that saline arthrography is feasible and comparable to saline podotrochlear bursography for producing podotrochlear bursa distension and separation of the structures of the podotrochlear apparatus on nonweight bearing limbs evaluated with low‐field MRI. Clinical evaluation of saline arthrography on live animals is needed to determine if this technique is safe and effective as an alternative to saline podotrochlear bursography in horses with suspected pathology of the podotrochlear apparatus.  相似文献   

4.
Abnormalities of the facies flexoria of the distal phalanx (FF) of the horse associated with podotrochlear syndrome have been scarcely described in the literature. The objective of this retrospective study was to determine correlation between modification of the FF and lesions of the podotrochlear apparatus. This study includes 100 horses referred for forelimb lameness that underwent a standardized magnetic resonance (MR) imaging protocol of the affected foot. Of the 100 MR studies, 74 had podotrochlear lesions and 26 free of podotrochlear lesions served as controls. A comparison of the FF compact bone thickness between affected and control feet was performed. Presence and location of a deep digital flexor tendon (DDFT) lesion was noted. Grading systems were used to score: FF osseous resorption, FF bone marrow lesion, FF sclerosis and abnormalities of the navicular bursa and the distal interphalangeal joint. Compact bone thickness of the FF was not increased in case of tendinopathy of the DDFT or other podotrochlear lesions (P = .86). Significant correlation was observed between osseous resorption of the FF at the level of the distal recess of the navicular bursa and synovial proliferation of the navicular bursa (P = .05). Compact bone thickening at the DDFT enthesis is not predictive of podotrochlear syndrome and should rather be considered as an interindividual anatomical variation. Navicular bursitis may play a role in osseous resorption of the FF.  相似文献   

5.
Diffusion of drugs injected into the distal interphalangeal joint or the navicular (podotrochlear) bursa can influence diagnosis and treatment of foot pain. Previous anatomical and radiographic studies of the communication between these synovial structures have produced conflicting results and did not identify the location of any communication if present. This anatomic study aimed to assess the presence and site of communication between the distal interphalangeal joint and the navicular bursa in the horse by computed tomography arthrography. Sixty‐six pairs of cadaver forelimbs were injected with contrast medium into the distal interphalangeal joint and imaged by computed tomography arthrography. The presence of a communication, location of the communication and additional structural changes were assessed. Navicular bursa opacification occurred in 7 distal limbs (5.3%) following distal interphalangeal joint injection. One limb showed a communication through the T‐ligament and 6 limbs showed a communication through the distal sesamoidean impar ligament. In 3 cases, the communication through the distal sesamoidean impar ligament was associated with a distal border fragment. Our study showed that communication between the distal interphalangeal joint and navicular bursa is uncommon and inconsistent. Clinically, the presence of a communication could (1) influence the interpretation of diagnostic analgesia of the distal interphalangeal joint or the navicular bursa by facilitating the diffusion of local anaesthetic between these structures; (2) allow the drug and its potential adverse effects to spread from the treated synovial cavity to the non‐targeted synovial cavity; (3) be responsible for the failure of joint drainage in the case of sepsis.  相似文献   

6.
Synovitis of the navicular bursa is common in performance horses. The objective of this study was to describe an ultrasound‐guided technique to inject a distended navicular bursa and to evaluate its feasibility for use by a clinician not trained in the technique. Twenty distal limbs of horses of various breeds and sizes were used. To produce synovial distension, the navicular bursa of each limb was injected with contrast medium using a lateral approach and radiography was performed to confirm that the contrast medium was distending the bursa. The digit was positioned with the distal interphalangeal joint in hyperextension. A microconvex ultrasound probe was placed in the hollow of the pastern, palmar to the middle phalanx and the region was assessed in a transverse plane slightly oblique to the horizontal plane. The ultrasound probe was rotated to visualize both the lateral and medial recesses and to select which side was more distended to inject. A 21G 0.8 × 50 mm needle was inserted abaxially to the probe in the plane of the ultrasound beam into the proximal recess of this navicular bursa and a methylene blue solution was injected. Following injection, dissection was performed to assess whether the navicular bursa had been successfully injected. This ultrasound‐guided technique was reliably performed with a success rate of 68%. The success of injection is influenced by hyperextension of the foot, quality of ultrasound images and degree of distension of the bursa.  相似文献   

7.
Foot pain is the most common cause of lameness in horses. In sport horses, podotrochlear syndrome (‘navicular syndrome’) is reported to be the most frequent condition affecting the front foot. Ultrasonography has the potential to detect damage to the soft tissues as well as the bone surfaces; in some clinics it has become the technique of choice for the identification and documentation of many podotrochlear injuries. The purpose of this paper is to review the main pathological conditions of the proximal part of the podotrochlear apparatus (PTA) that can be diagnosed ultrasonographically, focusing on the deep digital flexor tendon (DDFT), podotrochlear bursa (PTB) and distal digital annular ligament (DDAL). Potentially significant ultrasonographic findings of the DDFT include thickening of one or both lobes, longitudinal tears, focal or diffuse changes in echogenicity, irregularities of the dorsal border and adhesions between the DDFT and the proximal sesamoidean ligament and/or distal sesamoid bone. Deep digital flexor tendon injuries are often associated with concurrent lesions of the PTB (acute to chronic bursitis) and of the DDAL (desmopathy). Both feet should be routinely examined as lesions of the PTA are often bilateral. We currently consider that ultrasonography should be routinely employed as the primary diagnostic procedure to complement radiography of the equine foot.  相似文献   

8.
A technique for regional delivery of contrast medium to the foot of the horse to increase the diagnostic utility of computed tomography (CT) for the characterization of soft tissue structures within the hoof capsule was developed. An intraarterial catheter was placed under ultrasound guidance into the medial palmar artery at the level of the carpus to facilitate a steady-state infusion of iodinated contrast medium. Two 5 mm collimated contiguous acquisition CT scans were performed in 10 horses without lameness or radiographic evidence of distal sesamoid bone degeneration. CT examination was performed before and during regional arterial infusion of iodinated contrast medium administered at a rate of 2 ml/s. Cross-sectional area and mean pre- and post-contrast attenuation of the deep digital flexor tendon and the collateral ligaments of the distal interphalangeal joint were quantified from CT images. Soft tissue anatomy of the foot was also qualitatively characterized from pre- and postcontrast images. Catheterization was successful and without complication in all horses. The evaluated tendons and ligaments were clearly visible and had a small (8-20 Hounsfield Unit) but significant (P < 0.05, paired t-test) increase in attenuation during the steady-state infusion of contrast medium. This study should enhance the diagnostic potential of CT by providing baseline quantitative data for comparison with horses affected with soft tissue injuries in the distal extremity causing lameness that is alleviated with a palmar digital nerve block.  相似文献   

9.
REASONS FOR PERFORMING STUDY: Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. HYPOTHESES: Abnormalities of the collateral sesamoidean ligaments (CSLs), distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), navicular bone, navicular bursa, distal interphalangeal (DIP) joint or collateral ligaments (CLs) of the DIP joint may contribute to palmar foot pain. METHODS: Feet were selected from horses with a history of unilateral or bilateral forelimb lameness of at least 2 months' duration that was improved by perineural analgesia of the palmar digital nerves, immediately proximal to the cartilages of the foot (Group 1, n = 32); or from age-matched control horses (Group 2, n = 19) that were humanely destroyed for other reasons and had no history of forelimb foot pain. Eight units of tissue were collected for histology: the palmar half of the articular surface of the distal phalanx, including the insertions of the DDFT and DSIL; navicular bone and insertion of the CSLs; DDFT from the level of the proximal interphalangeal (PIP) joint to 5 mm proximal to its insertion; synovial membrane from the palmar pouch of the DIP joint and the navicular bursa; CLs of the DIP joint and DSIL. The severity of histological lesions for each site were graded. Results were compared between Groups 1 and 2. RESULTS: There was no relationship between age and grade of histological abnormality. There were significant histological differences between groups for lesions of the flexor aspect, proximal and distal borders, and medulla of the navicular bone; the DSIL and its insertion and the navicular bursa; but not for lesions of the CSLs, the dorsal aspect of the navicular bone, distal phalanx and articular cartilage, synovium or CLs of the DIP joint. CONCLUSIONS: Pathological abnormalities in lame horses often involved not only the navicular bone, but also the DSIL and navicular bursa. Abnormalities of the navicular bone medulla were generally only seen dorsal to lesions of the FFC. POTENTIAL RELEVANCE: Adaptive and reactive change may be occurring in the navicular apparatus in all horses to variable degrees and determination of the pathogenesis of lesions that lead to pain and biomechanical dysfunction should assist specific preventative or treatment protocols.  相似文献   

10.
  相似文献   

11.
OBJECTIVE: To determine history, clinical and radiographic abnormalities, and outcome in horses with signs of navicular area pain unresponsive to corrective shoeing and systemic nonsteroidal anti-inflammatory drug administration that were treated with an injection of corticosteroids, sodium hyaluronate, and amikacin into the navicular bursa. DESIGN: Retrospective study. ANIMALS: 25 horses. PROCEDURE: Data collected from the medical records included signalment, history, horse use, severity and duration of lameness, shoeing regimen, results of diagnostic anesthesia, radiographic abnormalities, and outcome. RESULTS: 17 horses had bilateral forelimb lameness, 7 had unilateral forelimb lameness, and 1 had unilateral hind limb lameness. Mean duration of lameness was 9.2 months. All horses had been treated with corrective shoeing and nonsteroidal anti-inflammatory drugs for at least 6 months; 18 had previously been treated by injection of corticosteroids and sodium hyaluronate into the distal interphalangeal joint. Fourteen horses had mismatched front feet, and 21 horses had signs of pain in response to application of pressure over the central aspect of the frog. Palmar digital nerve anesthesia resulted in substantial improvement in or resolution of the lameness in all horses. Twenty horses (80%) were sound and returned to intended activities 2 weeks after navicular bursa treatment; mean duration of soundness was 4.6 months. Two horses that received numerous navicular bursa injections had a rupture of the deep digital flexor tendon at the level of the pastern region. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that navicular bursa treatment may provide temporary improvement in horses with signs of chronic navicular area pain that fail to respond to other treatments.  相似文献   

12.
  相似文献   

13.
REASONS FOR PERFORMING STUDY: Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. HYPOTHESES: Abnormalities of the deep digital flexor tendon (DDFT) may contribute to palmar foot pain; ageing degenerative changes may be seen in horses free from lameness; and horses with lameness are likely to have a greater severity of abnormalities than age-matched horses with no history of foot pain. METHODS: Feet were selected from horses with a history of uni- or bilateral forelimb lameness of at least 2 months' duration. Histology of the DDFT from the level of the proximal interphalangeal joint to its insertion were examined and the severity of lesions for each site graded. Associations between lesions of the navicular bone, collateral sesamoidean ligaments (CSL), distal sesamoidean impar ligament, navicular bursa, distal interphalangeal (DIP) joint synovium and collateral ligaments of the DIP joint and DDFT were assessed. RESULTS: There was no relationship between age and grade of histological abnormality of the DDFT. There were significant histological differences between groups for lesions of the dorsal layers of the DDFT, but not for lesions of the palmar aspect. There were significant associations between histological grades for the superficial dorsal layer of the DDFT and flexor aspect of the navicular bone; and between the deep dorsal layer of the DDFT and the proximal border and medulla of the navicular bone. The navicular bursa grade was correlated with grades for the superficial dorsal, deep dorsal and deep palmar layers of the DDFT. The histological grades for the CSL and the superficial dorsal layer of the DDFT were also associated. CONCLUSIONS: Pathological abnormalities in lame horses often involved the DDFT in addition to the navicular bone. Vascular and matrix changes may precede changes in the fibrocartilage of the navicular bone. POTENTIAL RELEVANCE: Identification of factors leading to vascular changes within the interstitium of the DDFT and changes in matrix composition, may help in future management of palmar foot pain.  相似文献   

14.
Reasons for performing study: Hyperintense signal is sometimes observed in ligaments and tendons of the equine foot on standing magnetic resonance examination without associated changes in size and shape. In such cases, the presence of a true lesion or an artifact should be considered. A change in position of a ligament or tendon relative to the magnetic field can induce increased signal intensity due to the magic angle effect. Objectives: To assess if positional rotation of the foot in the solar plane could be responsible for artifactual changes in signal intensity in the collateral ligaments of the distal interphalangeal joint and in the deep digital flexor tendon. Methods: Six isolated equine feet were imaged with a standing equine magnetic resonance system in 9 different positions with different degrees of rotation in the solar plane. Results: Rotation of the limb induced a linear hyperintense signal on all feet at the palmar aspect of one of the lobes of the deep digital flexor tendon and at the dorsal aspect of the other lobe. Changes in signal intensity in the collateral ligaments of the distal interphalangeal joint occurred with rotation of the limb only in those feet where mediolateral hoof imbalance was present. Conclusions: The position and conformation of the foot influence the signal intensity in the deep digital flexor tendon and in the collateral ligaments of the distal interphalangeal joint. Potential relevance: The significance of increased signal intensity in the deep digital flexor tendon and in the collateral ligaments of the distal interphalangeal joint should be interpreted with regard to the position and the conformation of the foot.  相似文献   

15.
Lesions of the distal deep digital flexor tendon (DDFT) are frequently diagnosed using MRI in horses with foot pain. Intralesional injection of biologic therapeutics shows promise in tendon healing; however, accurate injection of distal deep digital flexor tendon lesions within the hoof is difficult. The aim of this experimental study was to evaluate accuracy of a technique for injection of the deep digital flexor tendon within the hoof using MRI‐guidance, which could be performed in standing patients. We hypothesized that injection of the distal deep digital flexor tendon within the hoof could be accurately guided using open low‐field MRI to target either the lateral or medial lobe at a specific location. Ten cadaver limbs were positioned in an open, low‐field MRI unit. Each distal deep digital flexor tendon lobe was assigned to have a proximal (adjacent to the proximal aspect of the navicular bursa) or distal (adjacent to the navicular bone) injection. A titanium needle was inserted into each tendon lobe, guided by T1‐weighted transverse images acquired simultaneously during injection. Colored dye was injected as a marker and postinjection MRI and gross sections were assessed. The success of injection as evaluated on gross section was 85% (70% proximal, 100% distal). The success of injection as evaluated by MRI was 65% (60% proximal, 70% distal). There was no significant difference between the success of injecting the medial versus lateral lobe. The major limitation of this study was the use of cadaver limbs with normal tendons. The authors conclude that injection of the distal deep digital flexor tendon within the hoof is possible using MRI guidance.  相似文献   

16.
The medical records of 38 horses with puncture wounds of the navicular bursa were reviewed. Only 12 horses had a satisfactory outcome (breeding or riding). Of the remaining 26 horses, 19 were euthanized, five were sold due to persistent severe lameness, one died, and one was lost to long-term follow-up. Different combinations of conservative management prior to surgical debridement and drainage of the navicular bursa were unsuccessful in resolving the condition. Horses that were treated surgically within 1 week of the injury and had a hind leg affected had the best chance of a satisfactory outcome. Additional wound debridement was necessary in 15 horses after initial surgical treatment. The most common complications encountered were navicular bone osteomyelitis and sepsis of the deep digital flexor tendon. Thirteen of 14 horses that had rupture of the deep digital flexor tendon and subluxation of the distal interphalangeal joint had an unsatisfactory outcome. One mare subsequently developed ankylosis of the distal interphalangeal joint and was a useful brood mare. Two horses that had biaxial palmar digital neurectomy because of persistent lameness were later euthanized because of navicular bone fracture and rupture of the deep digital flexor tendon. Results from limited numbers of bacterial cultures and antibiotic sensitivities suggest that penicillin and an aminoglycoside antibiotic should be used as initial antibiotic therapy. Immediate surgical debridement and appropriate antibiotic treatment are recommended as the minimum therapy for penetrating wounds of the navicular bursa in horses.  相似文献   

17.
Analgesia usually occurs within 5 min after administration of local anaesthetic solution into joints or around nerves in the distal portion of the limb. Gait should be assessed within 10 min after diagnostic regional analgesia of the distal portion of the limb because rapid diffusion of anaesthetic solution can result in anaesthesia of other nerve branches, thus confusing results of the examination. A palmar digital nerve block (PDNB) anaesthetises most of the foot, including the distal interphalangeal (DIP) joint (coffin joint), rather than just the palmar half of the foot, as was once commonly believed. To avoid partially anaesthetising the proximal interphalangeal joint (pastern joint), the palmar digital nerves should be anaesthetised near or distal to the proximal margin of the collateral cartilages. Clinicians should be aware that an abaxial sesamoid nerve block (ASNB) may ameliorate or abolish pain within the metacarpo/metatarso‐phalangeal joint (fetlock joint). Mepivacaine administered into the DIP joint desensitises the DIP joint and probably the palmar digital nerves to also cause anaesthesia of the navicular bursa, the navicular bone, the toe region of the sole, the digital portion of the deep digital flexor tendon (DDFT) and the distal portions of the collateral ligaments of the DIP joint. When a large volume of mepivacaine HCl (e.g. 10 ml) is administered, the heel region of the sole may also be desensitised. Only a small percentage of horses with disease of the collateral ligament(s) of the DIP joint show a significant improvement in lameness after intra‐articular analgesia of the DIP joint, and no horse is likely to improve after intrabursal analgesia of the navicular bursa. A PDNB, however, improves lameness substantially in most horses that are lame because of disease of the collateral ligament(s) of the DIP joint, and all affected horses are likely to become sound after an abaxial sesamoid nerve block. The degree of improvement in lameness associated with injury to one or both collateral ligaments of the DIP joint after PDNB is determined by the extent of the injury and the level at which the palmar digital nerves are anaesthetised. The further proximal the level of the injury within the collateral ligament, the less likely that lameness is ameliorated by analgesia of the DIP joint or a PDNB. Verschooten's technique appears to be the most accurate technique for centesis of the navicular bursa. Even though analgesia of the DIP joint results in analgesia of the navicular bursa, analgesia of the navicular bursa does not result in analgesia of the DIP joint. Pain arising from the DIP joint can probably be excluded as a cause of lameness when lameness is attenuated by analgesia of the navicular bursa. Analgesia of the digital flexor tendon sheath (DFTS) is likely to desensitise only structures that are contained within or border on the sheath itself (i.e. the superficial and deep digital flexor tendons, the straight and oblique distal sesamoidean ligaments, the annular ligaments of the fetlock and pastern, and the portion of the DDFT that lies within the foot). Because lameness caused by disease of the DDFT within the foot may fail to improve appreciably after analgesia of the palmar digital nerves, the DIP joint, or the navicular bursa, a portion of the DDFT within the foot and distal to the DFTS probably receives its sensory supply from more proximal deep branches of the medial and lateral palmar digital nerves that enter the DFTS. Performing intrathecal analgesia of the DFTS on horses with lameness that is unchanged after anaesthesia of the palmar digital nerves but resolves after an ASNB, may be useful in localising lameness to that portion of the DDFT that lies within the foot. Resolution of lameness after intrathecal analgesia of the DFTS justifies suspicion of a lesion within the digital portion of the DDFT or within structures contained within the DFTS. The belief that concurrent or sequential intra‐articular administration of medication substantially increases the risk of joint infection or that inflammation caused by the local anaesthetic solution may dampen the therapeutic response to intra‐articular medication appears to be unfounded.  相似文献   

18.
REASONS FOR PERFORMING STUDY: The differential diagnosis of foot pain has long proved difficult and the use of magnetic resonance imaging (MRI) offers the opportunity to further the clinical understanding of the subject. OBJECTIVES: To determine the incidence of deep digital flexor tendon (DDFT) injuries in a series of 75 horses with lameness associated with pain localised to the digit, with no significant detectable radiographic or ultrasonographic abnormalities, using MRI; and to describe a variety of lesion types and relate DDF tendonitis with anamnesis, clinical features, response to local analgesic techniques and nuclear scintigraphic and ultrasonographic findings. METHODS: All horses undergoing MRI of the front feet between January 2001 and October 2002 were reviewed and those with DDFT injuries categorised according to lesion type; horses with primary tendonitis (Group I) and those with concurrent abnormalities of the navicular bone considered to be an important component of the lameness (Group II). The response to perineural analgesia of the palmar digital nerves and palmar (abaxial sesamoid) nerves, intra-articular analgesia of the distal interphalangeal (DIP) joint and analgesia of the navicular bursa were reviewed. The result of ultrasonography of the pastern and foot was recorded. Lateral, dorsal and solar pool and bone phase nuclear scintigraphic images were assessed subjectively and objectively using region of interest (ROI) analysis. RESULTS: Forty-six (61%) of 75 horses examined using MRI had lesions of the DDFT considered to be a major contributor to lameness. Thirty-two horses (43%) had primary DDFT injuries and 14 (19%) a combination of DDF tendonitis and navicular bone pathology. Lesions involved the insertional region of the tendon alone (n = 3), were proximal to the navicular bone (n = 23) or were at a combination of sites (n = 20). Lesion types included core lesions, focal and diffuse dorsal border lesions, sagittal plane splits, insertional injuries and lesions combined with other soft tissue injuries. Many horses had a combination of lesion types. Lameness was abolished by palmar digital analgesia in only 11 of 46 horses (24%). Twenty-one of 31 horses (68%) in Group I showed > 50% improvement in lameness after intra-articular analgesia of the DIP joint, whereas 11 of 12 horses (92%) in Group II had a positive response. Twelve of 18 horses (67%) in Group I had a positive response to analgesia of the navicular bursa. Nineteen horses had lesions of the DDFT extending proximal to the proximal interphalangeal joint seen using MRI, but these were identified ultrasonographically in only 2 horses. Scintigraphic abnormalities suggestive of DDFT injury were seen in 16 of 41 horses (41%), 8 in pool phase images and 8 in bone phase images. CONCLUSIONS AND POTENTIAL RELEVANCE: DDFT injuries are an important cause of lameness associated with pain arising from the digit in horses without detectable radiographic abnormalities. Lameness is not reliably improved by palmar digital analgesia, but may be improved by intra-articular analgesia of the DIP joint in at least 68% of horses. Ultrasonography is not sensitive in detecting lesions of the DDFT in the distal pastern region, but a combination of pool and bone phase scintigraphic images of the digit is helpful in some horses. Further follow-up information is required to determine the prognosis for horses with lesions of the DDFT in the digit and to establish whether this is related to lesion severity and/or location.  相似文献   

19.
Navicular syndrome is a multifactorial disease process in horses with multiple structures in the foot contributing to lameness. Surgical debridement is a treatment option for lesions of the navicular bursa and deep digital flexor tendon. This retrospective case series describes the magnetic resonance imaging (MRI) appearance of the navicular bursa following bursoscopy. Seven horses (three being bilaterally affected) with forelimb lameness isolated to the foot, and pre- and post-operative MRI were included. All limbs had concurrent lesions associated with the deep digital flexor tendon, navicular bone, impar ligament, collateral sesamoidean ligament and/or distal interphalangeal joint. All bursae developed or had progression of proliferative bursal tissue following surgery. At recheck MRI, following rehabilitation protocols, almost all horses had improved to resolved lameness with relatively unchanged concurrent lesions despite the navicular bursa appearance worsening. Outcomes for return to work were poor with only two horses going back to the previous level of work.  相似文献   

20.
REASONS FOR PERFORMING STUDY: Centesis of the bicipital bursa using an 8.9 cm long spinal needle has been reported but the alternative of employing a 3.8 cm long hypodermic needle requires validation. OBJECTIVE: To compare the efficacy of 2 different methods of centesis of the bicipital bursa and to evaluate the usefulness of ultrasonographic imaging to determine the location of solution administered when centesis of the bursa is attempted. METHODS: For Trial 1, 6 clinicians, who had no previous experience of centesis of the bicipital bursa, attempted to inject a solution composed of an aqueous radiopaque contrast medium and physiological saline solution (PSS) into the bicipital bursae of 2/12 horses using the previously described distal approach to inject one bursa and a proximal approach to inject the contralateral bursa. The bicipital tendon and bursa were examined ultrasonographically before and after injection; and both shoulders were examined radiographically to identify the location of the medium. In Trial 2, another 6 clinicians, also with no previous experience of centesis, repeated Trial 1, using 6 horses, but the radiopaque contrast medium was mixed with air instead of PSS. RESULTS: Accuracy of centesis using the proximal approach was 39% and that of the distal approach 28%. Ultrasonographic examination of the shoulder allowed the location of solution and air to be accurately predicted in all 12 shoulders examined. CONCLUSIONS: Clinicians who have had no previous experience performing centesis of the bicipital bursa are unlikely to be successful in centesis using either approach. Radiographic examination after injecting a radiopaque contrast medium may be necessary to assess the success of centesis especially if bursal fluid is not obtained during centesis. Injecting air along with the radiopaque contrast medium provides more accurate ultrasonographic confirmation of centesis and better radiographic definition than does injection without air.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号