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1.
CASE DESCRIPTION: A 12-year-old Standardbred gelding was referred for swelling of the right metacarpophalangeal joint. CLINICAL FINDINGS: Ultrasonography of the right metacarpal area revealed hypoechoic areas in the right digital sheath and metacarpophalangeal joint consistent with synovial effusion. Radiography of the right metacarpophalangeal joint revealed lysis of the axial border of the proximal sesamoid bones. Aspergillus fumigatus was detected on fungal culture of synovial fluid. TREATMENT AND OUTCOME: Regional limb perfusion (150 mg of amikacin in 60 mL of saline [0.9% NaCl] solution perfused for 30 minutes) was performed 2 and 4 days after admission. Itraconazole (5 mg/kg [2.27 mg/lb], PO, q 24 h) was administered for approximately 9 weeks. Joint lavage with amikacin (500 mg) in 1 L of saline solution was performed 4 times. Three months after discharge, the owner reported that the horse was mildly lame during trotting but was moving freely and comfortably during all gaits and had gained a considerable amount of weight. Because the osteoarthritis was not expected to improve and because it was recommended that the horse not return to purposeful exercise, the owner decided to retire the horse from racing. CLINICAL RELEVANCE: Various diagnostic imaging methods and fungal cultures are useful for diagnosing fungal osteomyelitis of the axial borders of the proximal sesamoid bones in horses. Fungal osteomyelitis of the sesamoid bones and erosive arthritis should be considered as a differential diagnosis for horses in which corticosteroids have been administered intra-articularly.  相似文献   

2.
OBJECTIVE: To determine clinical, radiographic, and scintigraphic abnormalities in and treatment and outcome of horses with trauma-induced osteomyelitis of the proximal aspect of the radius. DESIGN: Retrospective study. ANIMALS: 5 horses. PROCEDURE: Data collected from the medical records included signalment; history; horse use; degree of lameness; radiographic, ultrasonographic, and scintigraphic findings; treatment; and outcome. RESULTS: Duration of lameness prior to referral ranged from 14 to 60 days. Mean severity of lameness was grade 3 of 5, and all horses had a single limb affected. All horses had signs of pain during elbow joint manipulation and digital palpation over the lateral aspect of the proximal end of the radius. Radiographic lesions consisted of periosteal proliferation, osteolysis, and subchondral bone lysis. Scintigraphy in 3 horses revealed intense pharmaceutical uptake diffusely involving the proximal end of the radius. Two horses had sepsis of the elbow joint. All horses were treated with antimicrobials long-term; 1 horse was also treated by local perfusion of the radial medullary cavity through an indwelling cannulated screw. At follow-up, all horses had returned to their previous function. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that osteomyelitis of the proximal end of the radius can result from a traumatic injury to the antebrachium. Because lesions may be an extension of septic arthritis, a thorough examination of the wound area and elbow joint is recommended. Prolonged systemic antimicrobial treatment can result in a successful outcome.  相似文献   

3.
An account of infectious juvenile osteomyelitis, epiphysitis and arthritis in a 14-week-old dalmation dog is described. It had a three-week history of left forelimb lameness and a painful shoulder joint. Radiography revealed radiolucency of the proximal humeral epiphysis, with the physis and metaphysis slightly involved. A deformed epiphysis and a short left humerus were found at necropsy. Staphylococcus inter-medius bacteria were isolated from the humeral epiphysis and shoulder joint. Histopathology demonstrated epiphyseal osteomyelitis, dyschondroplasia, fibrosis and arthritis.  相似文献   

4.
A 2‐day‐old Warmblood filly was presented for examination of an angular limb deformity of the left front limb and an upright conformation of both metacarpophalangeal joints. Radiological examination revealed bilateral absence of the metacarpophalangeal joint space with fusion of the third metacarpal bone and first phalanx (synostosis). No treatment was undertaken. The filly was readmitted to the clinic 10 weeks later for bilateral front limb lameness. On radiological examination, the synostosis of the front metacarpophalangeal joints was still present. Physitis of the distal growth plate of the right third metacarpal bone and proximal growth plate of the right proximal phalanx, and an avulsion fracture of the palmaromedial and proximal aspect of the left middle phalanx, with a cystic like lesion on the medial aspect of distal first phalanx and proximal middle phalanx were diagnosed. Given the poor prognosis, the foal was subjected to euthanasia. Post mortem examination confirmed the absence of the metacarpophalangeal joint space with a trabecular bony union between the third metacarpal bone and the first phalanx. A rudimentary joint capsule was present at the level of the absent joints as well as a small zone of articular cartilage, which invaginated over a short distance into the dorsal trabecular bone on the right front limb. On the medial aspect of the left proximal interphalangeal joint, a focal defect of articular cartilage with exposure of subchondral bone was observed. This is the first case report of a foal born with congenital aplasia of both metacarpophalangeal joints. Congenital malformations should be considered as differential diagnosis in lame foals or foals born with angular or flexural limb deformities.  相似文献   

5.
Using xeroradiographic techniques, both metacarpophalangeal regions of six quarter horse foals were radiographed at 1 day of age and at 2-week intervals until they were 6 weeks old, and then at 4-week intervals until they were 12 months old. Lateromedial and dorsopalmar xeroradiographs of each metacarpophalangeal region were made per examination; dorsomedial-palmarolateral projections of the left metacarpophalangeal joint of foal 6 were also made. The foals were weighed and measured at the withers immediately prior to each examination. Representative xeroradiographs were selected to demonstrate progression of the osteochondrosis (OCH) lesions in two of these foals. Radiographic evidence of osteochondrosis in the metacarpophalangeal region was first detected at 10 weeks and followed through 12 months of age. In one foal the lesions were bilaterally symmetric and involved the dorsoproximal aspect of the sagittal ridge of metacarpal 3; in the other, the left medial proximal sesamoid bone was affected. One of the sagittal ridge lesions progressed to osteochondritis dissecans by 26 weeks; the other sagittal ridge lesion and that of the sesamoid bone healed spontaneously, but residual radiographic evidence of the disease persisted throughout the study in both foals.  相似文献   

6.
Reasons for performing study: The aetiology of temporohyoid osteoarthropathy (THO) is unknown; both primary infectious and degenerative causes have been suggested. Hypothesis: There is a significant association between increasing age and severity of temporohyoid joint degeneration. To examine the histopathology of the temporohyoid articulation in aged horses and to compare the appearance of the joint with computed tomography (CT) and peripheral quantitative CT (pQCT). Methods: pQCT scans of the temporohyoid articulations were obtained bilaterally from 31 horses (range age 1–44 years) post mortem and images were graded by 2 blinded observers on 2 occasions for the presence of osteophytes, irregularity of the joint surface and mineralisation. Eight heads had been examined previously by CT, with the images similarly graded for the shape and density of the proximal stylohyoid bones, bone proliferation surrounding the joint, mineralisation of the tympanohyoid cartilage and the relationship of the petrous temporal bone to the stylohyoid bone. Sixteen temporohyoid joints were then evaluated histologically. Results: There was significant association between the mean pQCT degeneration score and age (rho = 0.75; P<0.0001), between the pQCT and CT score (rho = 0.63; P = 0.01) and between the degenerative changes identified within each temporohyoid joint within each horse (rho = 0.81; P<0.0001). Age‐associated changes included the development of a club shape by the proximal stylohyoid bone, rounding of the synostosis with the petrous temporal bone and extension of osteophytes from the petrous temporal bone to envelope the stylohyoid head and bridge the joint. In no horse was there any evidence of osteomyelitis within the petrous temporal bone, stylohyoid bone or tympanohyoid cartilage. Conclusions: This study provides evidence that age is associated with increasing severity of degenerative changes in the equine temporohyoid joint and that similar changes are commonly found bilaterally. Potential relevance: The changes identified appear similar, albeit milder to the changes reported in horses with THO, suggesting that degenerative, rather than infectious causes may underlie the aetiology of THO. Future work should be directed at examining the histopathology of clinical THO cases.  相似文献   

7.
Arthrodesis of the metacarpophalangeal joint was attempted in 9 adult horses, using a new external skeletal fixation device and autogenous cancellous bone graft. Four horses had excellent results, 2 horses had fair results, arthrodesis failed in 2 horses, and 1 horse fractured the third metacarpal bone. The advantages of the technique included minimal surgical trauma to the area of injury, immediate rigid fixation of the metacarpophalangeal joint, and access for treatment of soft-tissue lesions at the site of injury. Although pin loosening and pin-track infection were complications when the device was in place, all pin tracks healed without complications after device removal.  相似文献   

8.
Case records of 21 breeding bulls suffering from advanced septic claw disorders and treated with resection of the distal interphalangeal (= DIP) joint (n = 14), resection of the proximal interphalangeal joint (n = 1) and digit amputation (n = 6) were evaluated retrospectively (1992-2005) regarding the following parameters: breed, age, body mass, pre-treatment, localisation of disease, lameness degree, diagnosis, surgical method, outcome, postoperative survival time and return to breeding use. The mean age of the bulls was 3.6+/-1.7 years and the mean body mass 840.7 + 200.8 kg; range: 500-1200 kg), Surgery was carried out to treat the following conditions: white line infection (n = 9), sole ulcers (n = 5) with osteolysis of the distal sesamoid bone, the tuberculum flexorium, infection of the deep digital flexor tendon at insertion and the DIP-joint; osteomyelitis of the distal and middle phalanx with septic arthritis of the DIP-joint following deep penetrating wounds (n = 3); open fracture of the coffin bone with severe osteolysis/osteomyelitis and septic fibrino-purulent arthritis of the DIP-joint (n = 2); purulent arthritis of the proximal interphalangeal joint after a penetrating wound (n = 1) and a severe osteolysis/osteomyelitis of the coffin bone originating from a toe ulcer (n = 1). Three bulls were culled within 2-12 weeks after surgery due to postsurgical complications. In three bulls which were treated successfully six years ago, long-term follow-up information could not be obtained. Complete recovery was considered in 15 bulls.They returned to full breeding use three to four months after surgery, with a mean postoperative survival time of 24.1 months:21.2 months after joint resection and 27.2 months after amputation. At the time of this survey three bulls were still alive with 4,7 and 84 months after surgery, respectively. Both surgical methods were successful in breeding bulls, the resection of the distal interphalangeal joint is recommended as first option.  相似文献   

9.
The gait characteristics of a horse with chronic sesamoiditis of the left forelimb are described. On physical examination the affected metacarpophalangeal joint was foundto be enlarged. Extensive fibrosis on the palmar surface of the proximal sesamoid bones and in the suspensory ligament resulted in a reduced range of movement in the joint At rest the horsepointed the left toe and was reluctant to bear weight on that limb. Observation at the trot revealed an obvious head nod on the sound right diagonal. During the left diagonal stance phasethe head and neck were raised, the LF fetlock was held in a rigid upright position, and hyperextension of the joint was restricted.

Cinematographic analysis showed that the LF had a longer stance phase than the RF, due to anincreased anterior phase combined with a slower breakover (p<0.01). At the end of its stance phase the LF overlapped with both the RF and LH, so there was no left suspension. The rightdiagonal stance phase was followed by a short suspension before impact of the LF. With regard to linear measurements the horse took a longer step from the RF to LF and from the RH to LHthan for the contralateral pairs (p<0.01). As a result the distance between the RF and LH inthe right diagonal stance phase was significantly less than that between the LF and RH in the left diagonal stance phase (p<0.01).

Kinematic analysis showed that the sound RF made flat foot impact with the ground, whereas, at the end of the swing phase, the LF toe flipped up and impact was heel first The neck was elevated during the early part of the LF stance phase, until the limb had passed the midstance position when the poll fell, reaching its lowest level at the RF midstance position. Author's address: Department of Veterinary Anatomy, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan.  相似文献   


10.
OBJECTIVE: To determine the anatomic communications among compartments within the carpus, metacarpophalangeal and metatarsophalangeal joints, stifle joint, and tarsus in llamas. SAMPLE POPULATION: 88 limbs from 22 llamas necropsied because of reasons unrelated to disease of the carpus; tarsus; or metacarpophalangeal, metatarsophalangeal, or stifle joints. PROCEDURE: 1 compartment (randomly assigned) of each joint was injected with blue latex solution. Communication between joint compartments was determined by observation of latex in adjacent compartments following frozen sectioning. RESULTS: Of the 44 carpi, 30 (68%) had anatomic separation between the radiocarpal and middle carpal joints, whereas the remaining 14 (32%) had communication between the radiocarpal and middle carpal joints. In the metacarpophalangeal or metatarsophalangeal joints, medial and lateral joint compartments remained separate in 83 of 88 (94%) joints injected. The tibiotarsal and proximal intertarsal joints communicated in all tarsi examined, whereas 14 of 38 (37%) communicated between the proximal intertarsal and distal intertarsal joints. Communication between the distal intertarsal and tarsometatarsal joints was detected in 17 of 25 (68%) specimens; all 4 tarsal joints communicated in 11 of 42 (26%) specimens examined. Examination of 33 stifle joints that were successfully injected revealed communication between the femoropatellar, medial femorotibial, and lateral femorotibial joints. CONCLUSIONS AND CLINICAL RELEVANCE: These data suggest that it is important to determine the joint communications specific to each llama prior to treatment of septic arthritis. The metacarpophalangeal or metatarsophalangeal joint compartments may be considered separate, although the lateral and medial compartments infrequently communicate along the proximal palmar or plantar aspect.  相似文献   

11.
Traumatic disruption of the suspensory apparatus is a catastrophic injury in the horse. Although this injury has been described in the adult, little information is available in the foal. This paper describes 3 foals with metacarpophalangeal joint instability caused by traumatic disruption of the suspensory apparatus. Two foals had biaxial proximal sesamoid fractures in a single forelimb, and 1 foal had avulsion of the distal sesamoidean ligaments in 1 forelimb plus biaxial proximal sesamoid fractures in the other forelimb. The foals with single forelimb involvement were managed with splints, and the foal with bilateral disruption of the suspensory apparatus was euthanatized. Both treated foals resumed natural exercise at pasture. Both continue to be pasture sound 2 and 3 years after injury and are to be used for breeding. Management of disruption of the suspensory apparatus causing metacarpophalangeal joint instability using external support was effective for salvage of these 2 valuable foals for breeding.  相似文献   

12.
The authors are aware of only one previously described case of idiopathic infectious arthritis of the coxofemoral joint in a mature horse. The case described herein presented with clinical signs that localised pain to the proximal limb, subtle increased radiopharmaceutical uptake at the coxofemoral joint and an increase of the major acute phase protein, serum amyloid A in the horse's blood biochemistry. The latter finding led the authors to search initially for an infective process. Ultrasound guided aspiration of the coxofemoral joint yielded infected synovial fluid. Despite the duration of the condition, nonsurgical treatment allowed the horse to return to its previous, relatively modest, level of activity. This case is presented to supplement the single previously published case report of idiopathic adult coxofemoral infectious arthritis in the horse.  相似文献   

13.
Surgical removal of chip fractures of metacarpophalangeal joints arising from the cranial proximal margin of the first phalanx has been practiced for many years. Calcification developing within the joint capsule in the surgical area was observed frequently and was a cause for concern. Procedures to eliminate this problem were unsuccessful. A conservative program of rest and appropriate treatment for degenerative arthrosis until the lesion has healed has resulted in these horses becoming racing sound without having to resort to surgery.  相似文献   

14.
A horse with an open medial luxation of the left metatarsophalangeal joint with extensive cartilage and soft tissue damage and severe contamination of the wound was treated with a two-stage approach. In the first stage, the lesion was cleaned, the luxation was reduced, the wound was sutured and the limb was kept in a cast for a total time of 56 days. In the second stage, an arthrodesis of the affected joint was carried out, using a 13-hole broad 4.5 LCP plate. The limb was then kept in a cast for an additional total time of 56 days. At 70 days after the arthrodesis, the horse was brought in for a final check-up, and only a mechanical lameness remained at that time. No significant complications occurred. Previous case reports on the treatment of metatarso-/metacarpophalangeal luxations include neither cases as severe as the one presented here nor treatment by fetlock arthrodesis. This case illustrates that horses with a complicated, open luxation of the fetlock can be salvaged for breeding purposes.  相似文献   

15.
Reasons for performing study: The flexion test is used routinely as part of lameness and prepurchase examinations. However, little is known about the mechanisms that cause a positive response to a flexion test. Objective: To determine which anatomical regions play a role in a positive outcome of a flexion test of the distal aspect of a forelimb in a nonlame horse. Methods: Eight clinically sound Dutch Warmblood horses were subjected to a standardised flexion test (force 250 N, time 60 s) inducing a consistent lameness. To discriminate between different areas of the distal aspect of a forelimb, effects of various nerve blocks on the outcome of the flexion test were investigated. Low palmar digital, palmar at the abaxial aspects of the base of the proximal sesamoids, high palmar, ulnar and low 4‐point nerve blocks were performed. Flexion test induced lameness was scored before and after each nerve block in separate sessions. Results: The low palmar digital nerve blocks and nerve blocks of the palmar nerves at the abaxial aspect of the base of the proximal sesamoid bones had no significant effect on the flexion test induced lameness score. The ulnar, high palmar and, most dramatically, the low 4‐point nerve blocks all caused a significant (P<0.05) reduction in the flexion test induced lameness score. Conclusions: Anatomical structures (soft tissue nor synovial structures) located distal to the metacarpophalangeal joint appear to contribute only minimally to the outcome of a positive flexion test of the distal aspect of a forelimb in a clinically nonlame horse. The structures in the region of, and including, the metacarpophalangeal joint appear to contribute most to a positive flexion test of the distal aspect of a forelimb in a nonlame horse. Potential relevance: The flexion test of the distal aspect of a forelimb may be sensitive for investigating the metacarpophalangeal joint region in horses free from lameness, but may be less relevant for structures distal to this region.  相似文献   

16.
OBJECTIVE: To determine clinical, radiographic, and scintigraphic abnormalities in and outcome of horses with septic or nonseptic osteitis of the axial border of the proximal sesamoid bones. DESIGN: Retrospective study. ANIMALS: 8 horses. PROCEDURE: Data collected from medical records included signalment; history; horse use; severity and duration of lameness; results of perineural anesthesia, radiography, ultrasonography, and scintigraphy; and outcome following surgery. RESULTS: Five horses did not have any evidence of sepsis; the other 3 had sepsis of the metacarpophalangeal or metatarsophalangeal joint or the digital synovial sheath. All horses had a history of chronic unilateral lameness. Three of 5 horses improved after diagnostic anesthesia of the metacarpophalangeal or metatarsophalangeal joint; the other 2 improved only after diagnostic anesthesia of the digital synovial sheath. Nuclear scintigraphy was beneficial in localizing the source of the lameness to the proximal sesamoid bones in 4 horses. Arthroscopy of the palmar or plantar pouch of the joint or of the digital synovial sheath revealed intersesamoidean ligament damage and osteomalacia of the axial border of the proximal sesamoid bones in all horses. All 5 horses without sepsis and 1 horse with sepsis returned to their previous uses. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that osteitis of the axial border of the proximal sesamoid bones is a distinct entity in horses that typically is associated with inflammation of the associated metacarpointersesamoidean or metatarsointersesamoidean ligament and may be a result of sepsis or nonseptic inflammation. Arthroscopic debridement may allow horses without evidence of sepsis to return to their previous level of performance.  相似文献   

17.
OBJECTIVE: To evaluate the use of hydrothermal ablation of articular cartilage for arthrodesis in horses through investigation of the effects of joint lavage with physiologic saline (0.9% NaCI) solution (80 degrees C) for various treatment times on chondrocyte viability in the articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of cadaveric horse limbs. Sample Population-7 pairs of metacarpophalangeal and 8 pairs of metatarsophalangeal joints from 8 Thoroughbreds. PROCEDURE: The horses were euthanatized for reasons unrelated to musculoskeletal disease. On a random basis, 1 joint of each pair underwent intra-articular lavage for 5, 10, or 15 minutes with heated saline solution (80 degrees C); the other joint underwent sham treatment of similar duration with saline solution at 22 degrees C (control). Cartilage samples from the distal articular surface of metacarpus III (or metatarsus III), the proximal surface of the proximal phalanx, and the lateral and medial proximal sesamoid bones were assessed for chondrocyte viability via confocal microscopy and viability staining following enzymatic digestion. RESULTS: Compared with the control joints, findings of both viability assays indicated that the percentage of sites containing viable chondrocytes in heat-treated joints was decreased.Treatment hazard ratios of 0.048 (confocal microscopy) and 0.2 (digestion assay) were estimated. Histologically, periarticular soft tissues had minimal detrimental effects after heat treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Ex vivo intra-articular lavage with saline solution at 80 degrees C resulted in the death of almost all articular chondrocytes in the joint. This technique may be a satisfactory method for extensive cartilage ablation when performing arthrodesis by minimally invasive techniques.  相似文献   

18.
Proximal open comminuted fractures of the fourth metatarsal bone (Mt IV) in eight horses were treated by complete removal of the affected bone and antimicrobial therapy. Two horses had concurrent septic arthritis of the tarsocrural or distal tarsal articulations, and five horses had radiographic evidence of osteomyelitis and sequestration of the affected bone. Five horses became athletically sound for their intended use, two horses with septic arthritis had residual lameness but were pasture sound, and one horse was lost to follow-up. Excision of the entire bone appears to be an acceptable treatment of open comminuted fractures of the proximal one-third of Mt IV that do not respond to more conservative modes of therapy.  相似文献   

19.
An 8-year-old Thoroughbred gelding was determined to have a sagittal fracture of the central tarsal bone. Lag screw fixation of the fracture enabled the horse to return to jumping, although degenerative arthritis of the distal intertarsal joint was apparent radiographically 17 months after the injury.  相似文献   

20.
Four hundred and forty-five bovines with bone infection of the appendicular skeleton were selected for clinical and radiographic assessment. A distinction was made between hematogenous and post-traumatic origin (wound/fracture). Bone infection was classified into four types according to the site of infection: type 1 is metaphyseal and/or epiphyseal osteomyelitis close to the growth plate; type 2 is primary subchondral osteomyelitis mostly accompanied by septic arthritis; type 3 is infectious osteoarthritis with subchondral osteomyelitis implicating that infection in the subchondral bone originates from the infection. Type 4 summarizes bone infections which can not be categorized in the previous groups. Hematogenous osteomyelitis is 3.2 times more frequent than post-traumatic osteomyelitis. Within the different groups, the relation of hematogenous to post-traumatic infection changed significantly. In type 1 infection the ratio was 5/1, in type 2 the ratio was 8/1 and in type 3 it was 3/1. Epiphyseal or metaphyseal osteomyelitis exhibited early radiographic bone changes, whereas with infection eminating from the joint, the bone lesions were detected later, because the bone was infected as a consequence of a primary septic arthritis. In smaller bones, severe and complete bone destruction was often present. Hematogenous bone infection never involved the entire diaphysis. Actinomyces pyogenes was discovered to be the main etiologic agent, whether or not combined with anaerobes. Bone fragments from the metaphysis of young calves were subjected to the effect of pure cultures of different bacteria. Radiographic changes to the structure of the bone were not identified within 2 weeks. Rapid radiographic changes in osteomyelitis cannot be explained by the direct effect of the bacteria on bone tissue in vivo. General infections of the lungs, disorders of the intestines and other internal organs were rarely responsible for osteomyelitis or septic arthritis. Osteomyelitis and infectious osteoarthritis is probably often induced by external and internal traumatic events to joints and bones in cattle.  相似文献   

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