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1.
AIM: To describe the clinical, radiographic, and sonographic features of 15 dogs with bicipital tendinitis and tenosynovitis, classify them according to cause, and evaluate the long-term efficacy of treatment. METHODS: Dogs exhibiting forelimb lameness with pain localised to the biceps tendon were included in the study. Sonographic examination of the tendon and tendon sheath, and radiographic examination including positive contrast arthrograms of the shoulder joint were performed, and assessed for features consistent with biceps tendon disease. In some cases, synovial-fluid analysis and surgical investigation were also undertaken. The causes of the conditions were classified as either traumatic, mechanical, neoplastic or inflammatory. Dogs were treated conservatively with rest and anti-inflammatory drugs, or surgically by either transection of the transverse humeral ligament or tenodesis of the biceps tendon. Assessment of the effects of treatment was made by re-examination at six weeks and from information gained by telephone interview with the dog's owner at longer-term follow-up. RESULTS: Bicipital tendinitis and tenosynovitis were common causes of forelimb lameness in active, middle-aged or older, medium to large-breed dogs. The most sensitive physical tests for localising pain to the biceps apparatus were shoulder flexion with the elbow extended, focal digital pressure applied directly to the biceps origin, and the biceps retraction test. Sonographic assessment was found to be more sensitive than shoulder radiography or arthrography for characterising the lesion. Conservative treatment of 11 traumatic cases resulted in good or excellent function at long-term follow-up. One mechanical bicipital tendinitis secondary to mineral deposits within the supraspinatus tendon improved following transection of the transverse humeral ligament and removal of the deposits. One of two cases of inflammatory tendinitis/ tenosynovitis improved following tenodesis. One dog with neoplastic disease did not improve and was euthanased. CONCLUSIONS: The diagnosis of bicipital tendinitis and tenosynovitis requires a careful examination using a combination of physical tests. Of the ancillary tests, sonography was the most reliable, however information gained from all tests was useful in fully evaluating the biceps apparatus and shoulder joint. The classification system employed in this study was helpful in selecting a treatment protocol and determining the likely prognosis. 相似文献
2.
Paul Y. Barthez DrMéd Vét Joe P. Morgan DVM Vet med dr 《Veterinary radiology & ultrasound》1993,34(5):325-330
This paper describes seven dogs with traumatic bicipital tenosynovitis in which complete clinical, radiographic, and surgical evaluations were performed. All were adult dogs of medium to large breed and were presented with a chronic front limb lameness of several months' duration and shoulder muscle atrophy. Survey radiographs of the scapulohumeral joint showed new bone production almost exclusively in the region of the biceps tendon, i.e., the intertubercular groove and the supraglenoid tuberosity. Arthrograms in six of seven dogs revealed difficulty in filling or irregular filling of the bicipital tendon sheath, best seen on the mediolateral view of the shoulder. On surgical exploration, macroscopic lesions of the tendon and/or the sheath were observed in all dogs and included adhesions, fibrosis, scar tissue, edema, and thickening. Partial tear of the tendon was observed in three dogs. 相似文献
3.
Rupture of the biceps brachii tendon sheath was diagnosed in two dogs which were presented with chronic thoracic limb lameness. In each case, diagnosis was achieved by positive contrast arthrography, which revealed obvious leakage of contrast agent from the distal portion of the tendon sheath. Arthroscopy was performed in each affected shoulder joint and no other significant lesions were found. In one dog, concomitant bicipital tendinopathy was confirmed by histopathology. Both dogs were treated by bicipital tendon transposition, and tenodesis and both showed improvement in the degree of lameness following surgery. Tearing of the biceps brachii tendon sheath has not been reported previously but should be included in the differential diagnosis for shoulder lameness in the adult dog. 相似文献
4.
A 13-year-old Morgan gelding was examined for right forelimb lameness and tenosynovitis of the right common carpal sheath of the digital flexor tendons. The horse had moderate right forelimb lameness at the trot and marked effusion of the right common carpal sheath of the digital flexor tendons. Ultrasonographic examination revealed a soft tissue mass within the proximal pouch of the affected tendon sheath, located adjacent to the distal physis of the radius. Cytology and culture of the fluid revealed a sterile, eosinophilic tenosynovitis. Tenoscopic exploration confirmed the presence of a capsulated soft tissue mass. Thecotomy was required to fully debride the mass, which histology revealed to be a mast cell tumour. At 22 months postoperatively, the horse developed mild right forelimb lameness and eosinophilic tenosynovitis because of recurrence of the mastocytoma. Mastocytosis is a possible differential diagnosis in any horse exhibiting lameness associated with tenosynovitis. Surgical excision combined with rest and postoperative intrasynovial and systemic corticosteroids may be palliative. 相似文献
5.
This report describes an adult Quarter Horse gelding that was presented for evaluation of chronic tenosynovitis of the right common digital extensor tendon sheath. Radiographic and tenoscopic evaluation confirmed the presence of a periarticular osteophyte from the third metacarpal bone protruding into the common digital extensor tendon sheath. Tenoscopic surgical resection of the osteophyte and debridement of the affected tendon resolved the tenosynovitis and associated right forelimb lameness. Osteophytes in this location can be a source of focal traumatic tendonitis of the common digital extensor tendon which can lead to a chronic tenosynovitis of the common digital extensor tendon sheath. Tenoscopic debridement and lavage is a viable treatment option for chronic nonseptic common digital extensor tendinopathy and associated tenosynovitis. 相似文献
6.
Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for acute tendon sheath infections. 相似文献
7.
Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for acute tendon sheath infections. 相似文献
8.
Stenosing tenosynovitis of the abductor pollicis longus muscle causes chronic front limb lameness in dogs. The lesion, similar to de Quervain's tenosynovitis in people, is caused by repetitive movements of the carpus. Thirty dogs with front limb lameness, painful carpal flexion, and a firm soft tissue swelling medial to the carpus were examined prospectively. Seven dogs had bilateral abductor pollicis longus tenosynovitis. Radiographs of the carpus were characterized by a deeper radiolucent medial radial sulcus and bony proliferations medial and slightly cranial to the distal radius, resulting in stenosis of the tendon sheath and subsequent tendinitis. Ultrasonographic examination of the firm soft tissue swelling medial to the carpus was characterized by an irregular hypoechoic abductor pollicis longus tendon or tendinitis in 22 of 37 dogs. Nineteen of 37 abductor pollicis longus tendon sheaths were fluid-filled and all tendon sheaths were thickened, more hyperechoic, with small hyperechoic mineralizations embedded in the connective tissue of the abductor pollicis longus tendon sheath in 25 dogs. Enthesopathy of the abductor pollicis longus tendon was identified in seven dogs. While radiographs of stenosing tenosynovitis of the abductor pollicis longus are helpful in visualizing the deep radial sulcus and osteophytes medial to the distal radius, ultrasonography is useful to distinguish between lesions of the tendon or tendon sheath and to determine thickness and fluid content of the abductor pollicis longus tendon sheath. 相似文献
9.
Supraspinatus and biceps brachii tendinopathy in dogs 总被引：1，自引：0，他引：1
Calcifying tendinopathy was seen on radiographic views of the scapulohumeral joint in 12 of 183 (7 per cent) dogs reviewed retrospectively. Calcifying tendinopathy was identified only in large breed dogs, five being labradors. All the affected dogs, except one, were presented for unilateral thoracic limb lameness, which was typically of a chronic and intermittent pattern. Pain on manipulation of the scapulohumeral joint in the lame leg was present in eight of 12 dogs (67 per cent). Calcification of the supraspinatus tendon was seen in eight dogs and calcification of the biceps brachii tendon was seen in the other four dogs. Radiographic changes indicative of biceps brachii tendon avulsion were found in conjunction with calcification of the contralateral biceps brachii tendon in two dogs. Filling defects, indicative of bicipital tenosynovitis, were also seen in positive contrast arthrograms of two dogs with biceps brachii calcification. Of the eight dogs for which radiographic views of both scapulohumeral joints were available, six dogs had bilateral radiographic signs of calcifying tendinopathy. Overall, radiographic signs of calcifying tendinopathy were seen in 18 scapulohumeral joints, but lameness was apparent in only nine limbs, suggesting the lesion may at times be asymptomatic. Further prospective investigation of calcifying tendinopathy is needed to determine why lameness does not always appear to be associated with the presence of the lesion. 相似文献
10.
This report describes two dogs with bilateral bicipital tenosynovitis which were managed using double tenodesis. Surgical repair involved the attachment of the tendon to the humerus with a bone screw and plastic spiked washer, and a double Bunnell-Meyer suture. Six months postoperatively, neither of the treated dogs displayed any lameness on clinical examination. 相似文献
11.
OBJECTIVE: To determine the clinical and pathologic findings in dogs with primary bicipital tenosynovitis. ANIMALS: 19 dogs with 20 shoulder joints treated surgically for bicipital tenosynovitis and 8 shoulder joints from 4 clinically normal dogs. PROCEDURE: Histologic abnormalities of tendon sheaths of the biceps brachii in affected dogs were determined by use of comparison with findings in clinically normal dogs. Specimens were graded for inflammation, fibrosis, villous hypertrophy, vascular prominence, and synovial cell proliferation. Histopathologic results were statistically evaluated for relationship with clinical findings and treatment before surgery. RESULTS: Synovial villous hypertrophy and vascular prominence were the most consistent histologic findings in 16 and 14 of 20 affected joints, respectively. Evidence of inflammation was lacking in 6 joints. Ten joints had inflammatory cell infiltration of the tendon sheath. Plasma cells and lymphocytes were the most common infiltrates; however, the type and amount of inflammatory cell infiltrate were variable. Fibrosis of the tendon sheath was seen in 8 joints, and synovial cell proliferation was seen in 11 joints. Other changes included accumulation of hemosiderin, focal calcification, osseous metaplasia, lysis of collagen, and fibrocartilaginous metaplasia. No significant relationship was detected between histopathologic findings and clinical findings or treatment before surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Inflammation was more variable than hypothesized and may not be a consistent pathophysiologic feature of bicipital tenosynovitis. In some dogs, this disease may be the result of a degenerative process rather than an inflammatory process. 相似文献
12.
A Bohn M Papageorges B D Grant 《Journal of the American Veterinary Medical Association》1992,201(2):305-306
Ultrasonography and radiography were used to diagnose bicipital tenosynovitis and humeral osteitis in a horse with a history of lameness of 7 weeks' duration. Surgical exploration confirmed the diagnosis. 相似文献
13.
Nixon AJ Schachter BL Pool RR 《Journal of the American Veterinary Medical Association》2004,224(2):264-270
OBJECTIVE: To determine the clinical, radiographic, ultrasonographic, and arthroscopic findings associated with tenosynovitis of the carpal synovial sheath induced by exostoses that originate from the caudal surface of the physeal scar of the distal radius and determine the results of surgical removal of those exostoses in horses. DESIGN: Retrospective study. ANIMALS: 10 horses. PROCEDURE: Medical records of horses with effusion in the carpal synovial sheath and lameness evaluated from 1999 to 2003 were examined. RESULTS: All horses had a history of intermittent mild to moderate effusion of the carpal synovial sheath and lameness of 1 forelimb. Results of regional perineural and intrathecal anesthesia of the carpal synovial sheath confirmed that the lameness originated in the carpal synovial sheath. Radiography revealed exostoses originating from the caudal cortex of the distal radius at the level of the closed physis. Arthroscopy was performed for confirmation and removal of exostoses that penetrated the carpal synovial sheath and impinged on the deep digital flexor tendon. All horses returned to previous athletic activity. One horse had a recurrence of clinical signs 12 months after surgery, which resolved with medical treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Tenosynovitis of the carpal synovial sheath and lameness were caused by impingement of exostoses of the caudal radius on the lining and contents of the carpal synovial sheath. Although the clinical signs and surgical treatment were similar to that caused by osteochondromas, these exostoses developed at the level of the closed physis of the distal radius and were not radiographically or histologically similar to osteochondromas. 相似文献
14.
A 15-month-old, spayed female, Bernese mountain dog was presented to the Institute of Small Animal Surgery at the University of Zurich because of chronic left forelimb lameness. The referring veterinarian diagnosed pain in the left shoulder region and had treated the dog with systemic non-steroidal anti-inflammatory drugs and restricted exercise for a two-week period. The follow-up examination revealed only minimal improvement and therefore, the dog was referred for further diagnostic evaluation. Chronic bicipital tenosynovitis and tendinitis of the infraspinatus muscle was diagnosed based on survey radiographs, arthrography, ultrasound, computed tomography (CT), and synovial fluid cytology. The dog underwent three sessions of extracorporeal shockwave therapy and substantial clinical improvement was observed. On follow-up examinations, only mild left forelimb lameness was evident following exercise, and changes in the intertubercular groove and at the supraglenoid tuberosity appeared less active on radiographs and CT. However, six months following treatment, mild degenerative joint disease was apparent. 相似文献
15.
A new surgical approach to the infected fetlock joint is described in two cattle suffering from septic tenosynovitis of the lateral digital flexor tendon sheaths of the right lateral hind-digits with concurrent septic serofibrinous arthritis of the adjoining fetlock joints, caused by penetrating wounds. In both patients, the infected sheaths were opened and the superficial and deep digital flexor tendons were removed. Intraoperatively, a small entry through the fetlock joint capsule was detected, directly distal to the lateral proximal sesamoid bone. The tract was surgically enlarged and a second approach into the plantar fetlock joint pouch was created proximally by making a 3 cm long and 0.5 cm wide incision between the two lateral suspensory ligament branches. This allowed easy access to the plantar joint pouch, removal of fibrin clots and an effective joint lavage using 5L of sterile saline solution. The incisions of the fetlock joint capsules remained unsutured and were drained using soft polyurethane foam to preclude premature closure. The tendon sheath wounds remained unsutured. In both patients, the digital flexor tendon sheath and the fetlock joint were lavaged daily for the following three days. The infection was eliminated in both cattle and both fully recovered without residual lameness. 相似文献
16.
A 7-year-old Holsteiner gelding was presented with a left common digital extensor sheath effusion of one-year's duration. Radiographic examination revealed two extra-articular mineralised bodies adjacent to the dorsolateral carpometacarpal joint. Ultrasonography confirmed an intrathecal location of one mineralised body in the common digital extensor sheath, palmar fraying of the common digital extensor tendon and tenosynovitis. Ultrasound could not confirm whether the second mineralised body was intrathecal or located external to the common digital extensor sheath. Common digital extensor tenoscopy facilitated removal of both mineralised bodies and revealed a fistula communicating with the carpometacarpal joint. The mineralised bodies, initially thought to be synovial osteochondromas, were histologically identified as para-articular osteochondromas. There are no previously published reports of para-articular chondroma/osteochondroma in the horse. Despite surgical removal of the para-articular osteochondromas, concern for future extensor sheath distension remained given the communication between the carpometacarpal joint and common digital extensor sheath. 相似文献
17.
Five dogs of varying breeds, ranging from 4 to 8 years in age, were presented with clinical signs consistent with bicipital tenosynovitis. After failure of conservative treatment, each dog underwent shoulder arthroscopy. Following examination of the scapular humeral joint, the bicipital tendon was severed with a bipolar radiofrequency electrosurgical system. The arthroscopic procedure resulted in a good to excellent outcome for all five dogs. 相似文献
18.
M. Barba M. McMaster V. Albanese R. Cole F. Caldwell J. Schumacher 《Equine Veterinary Education》2014,26(7):347-352
A Percheron mare was presented for acute, severe lameness and marked swelling of the right forelimb after being cast. The mare was initially diagnosed with cellulitis of the forelimb but as her condition improved and the affected limb was able to bear more weight it became apparent that the limb was hyperextended at the level of the carpus. Widening of the palmar aspect of the middle carpal joint was observed radiographically. During ultrasonographic examination, excessive fluid in the carpal sheath and perithecal swelling were noted and tearing of the palmar carpal ligament was suspected. A dynamic brace was fabricated to prevent hyperextension of the carpus. After discontinuation of systemic antibiotics, the mare became febrile and forelimb lameness worsened. Cytology of fluid from the middle carpal joint confirmed joint sepsis and the mare was anaesthetised for arthroscopic examination. A tear in the palmar carpal ligament, characterised by focal fibre disruption and fibrillation, was identified during arthroscopic and tenoscopic examination. Communication between the carpal flexor tendon sheath and middle carpal joint was identified during these procedures. Both the middle carpal joint and carpal flexor tendon sheath were lavaged with physiological saline solution. Post operatively, swelling and lameness slowly resolved. Four months after discharge, the mare was sufficiently sound to be maintained at pasture. Viewed from its lateral aspect, the limb no longer appeared to be hyperextended from the carpus. 相似文献
19.
Chronic biceps brachii (BB) tendinopathy is a rare cause of lameness in horses that can be challenging to diagnose and treat successfully. This pathology is typically insidious in onset and unresponsive to conservative treatment. A 12-year-old Quarter Horse gelding presented for chronic severe lameness of the left forelimb that was localised to the left shoulder area. The horse was unresponsive to conservative management and surgical exploration revealed a grossly enlarged proximal BB tendon, a thickened fibrotic bicipital bursa and adhesions between the tendon, humerus and bursa. With standing sedation and local anaesthesia, the adhesions were debrided and 10 cm of the affected tendon was excised. Immediately post-operatively, the left forelimb lameness dramatically decreased. The horse recovered well and after rehabilitation returned to the previous level of athletic performance without evidence of lameness or gait abnormality. In this case, tenectomy of the chronic unresponsive BB tendinopathy, with associated bursal fibrosis and humeral adhesions, was successful and resulted in a return to previous athletic performance without complications. Standing excision of the BB tendon may be a viable treatment option for chronic BB tendinopathy and associated conditions when there is significant compromise to the integrity of the BB tendon. 相似文献
20.
T M Booth 《The Veterinary record》1999,145(7):194-198
Severe, chronic lameness in the left forelimb of a five-year-old Arab stallion was localised to the bicipital bursa by local anaesthesia and gamma scintigraphy. Radiographic and ultrasonographic examinations of the proximal humeral tubercles and bicipital bursa revealed new bone production in the region of the intertubercular grooves and irregularities in the density of the soft tissues of the bicipital tendon and bursa. An endoscopic examination of the bicipital bursa with a standard arthroscope under general anaesthesia was a useful diagnostic procedure. The stallion was euthanased, and marked fibrocartilage fibrillation and formation of adhesions were found postmortem, confirming a diagnosis of chronic fibrinous bursitis. 相似文献