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 109 毫秒
1.
An abnormal digital flexor tendon sheath was present in the mid to lower metacarpal region in a horse. Positive contrast radiography showed that it communicated with the carpal synovial sheath but not with the digital synovial sheath. Cytological and physical analysis of fluid from the abnormal tendon sheath revealed that it was compatible with normal synovial fluid. This abnormal tendon sheath was probably a congenital anomaly.  相似文献   

2.
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   

3.
OBJECTIVE: To evaluate the accuracy of a new technique for perineural injection of the lateral palmar nerve and to determine frequency of inadvertent injection into the carpal synovial sheath with this technique. STUDY DESIGN: Prospective experimental study. ANIMALS: Thirty equine cadaver forelimbs. METHODS: Each of 3 clinicians injected 0.5 mL of a 1% aqueous solution of new methylene blue as a marker at the medial aspect of the accessory carpal bone of 10 limbs. Immediately after each injection, the lateral palmar nerve was identified by dissection of and inspected for proximity of dye, and the carpal synovial sheath was inspected for the presence of dye. RESULTS: New methylene blue solution was observed to surround the nerve (29 limbs) or to lie within 2 mm of it (1 limb). Dye was not found in the carpal synovial sheath of any specimen. CONCLUSIONS: Using this technique, perineural injection of the lateral palmar nerve can be consistently achieved, and the carpal synovial sheath is unlikely to be penetrated by the needle during the procedure. CLINICAL RELEVANCE: The technique described provides an accurate and simple method for perineural injection of the lateral palmar nerve proximal to the origin of its deep branch. This technique can be used to anesthetize the lateral palmar nerve for diagnosis of pain originating in the palmaroproximal aspect of the metacarpus without risk of inadvertently desensitizing structures within the carpal synovial sheath.  相似文献   

4.
Cartilage oligomeric matrix protein (COMP) is a noncollagenous extracellular matrix protein found predominantly in cartilage, but also in tendon, ligament and meniscus. Studies in man have demonstrated that it may be used as a prognostic marker in rheumatoid arthritis and osteoarthritis. The present study investigated whether tendon injury contributes to serum and tendon sheath synovial fluid levels of COMP in horses. COMP levels, analysed by competitive ELISA, in the digital sheath synovial fluid were more than 10-fold higher than in the serum. Levels were significantly raised when tendon damage or sepsis was present within the tendon sheath but showed only mild, statistically insignificant, elevation in cases of tenosynovitis alone. COMP concentrations in serum were found to vary with age. Foals (age < or = 1 year) had significantly (P<0.001) higher levels in comparison to older control horses. Total COMP concentrations in an age-matched group with tendinitis were not significantly different from the control group. Measurements of COMP levels in tendon sheath synovial fluid are therefore useful in depicting processes in tendon tissue, while elevated serum levels are likely to be more representative of joint disease than tendinitis.  相似文献   

5.
During endoscopy (tenoscopy) of the distal aspect of the equine digital flexor tendon sheath (DFTS), the digital manica flexoria can be visualized connecting the distal branches of the superficial digital flexor tendon. However, this structure has been inconsistently described and variably named in the veterinary literature. The objectives of this study were to describe the presence, configuration and variability of the digital manica flexoria in the equine distal limb. Dissection of 144 equine cadaveric limbs revealed the presence of this structure in all the feet, although different types and conformations were identified. In the forelimbs, a membranous digital manica flexoria predominated (94%; < 0.001), in particular a synovial bridge type (83%; < 0.001). In the hindlimbs, a tendinous digital manica flexoria predominated (93%; < 0.001), in particular the oblique‐crossing of tendinous bundles (61%; < 0.001). Passage dorsal to the digital manica flexoria towards the distal DFTS was only possible in 22 of the 144 limbs, all forelimbs. Clinicians should be aware of the intra‐ and inter‐individual anatomical variations of the digital manica flexoria to avoid misinterpretation during ultrasonographic and tenoscopic examinations of the DFTS.  相似文献   

6.
The intimal lining cells of the synovium in joints have been studied morphologically and histochemically and shown to consist of macrophagic cells (type A) and fibroblast-like cells (type B). It is believed that the structure of the synovium in the tendon sheath is similar to that in the joint, but there have been only a few morphological studies of the tendon sheath. The present study revealed the cellular architecture of synovium in the tendon sheath of horses by histochemistry and scanning electron microscopy (SEM). Like the joint, the inner surface of the tendon sheath was covered with a cell-rich intimal layer. Acid phosphatase-positive A cells accumulated in the mesotendon but few in other regions. B cells were selectively immunolabeled with protein gene product (PGP) 9.5 antiserum and distributed in the entire length of the synovial intima in the tendon sheath. The synovial intima consisted of a surface layer rich in the processes of B cells and a deep layer containing cell bodies of B cells. Using SEM, B cells could be classified into two types according to the morphology of their processes. B cells of dendritic type were located mainly in the joint-side of the tendon sheath and extended branched processes to form a meshwork on the intimal surface. B cells of flat type were located in the skin-side of the tendon sheath and in the mesotendon. Their membranous processes extended in a horizontal direction and covered the intimal surface, resembling epithelium. It appears likely that the morphology and distribution of synovial intimal cells are influenced by various factors, such as the nature of the underlying tissues and the magnitude of mechanical stress.  相似文献   

7.
OBJECTIVE: To determine the outcome of horses with "complex" digital tenosynovitis treated by tenoscopic proximal annular ligament desmotomy and resection of synovial masses or adhesions, or both, within the digital sheath. STUDY DESIGN: Retrospective evaluation. ANIMALS OR SAMPLE POPULATION: Twenty-five horses with a clinical and ultrasonographic diagnosis of palmar or plantar proximal annular ligament constriction and ultrasonographic evidence of synovial masses or adhesions within the digital tendon sheath. METHODS: Each horse had tenoscopic surgery for annular ligament desmotomy combined with adhesiolysis and/or synovial mass resection. Mean follow-up time was 3.4 years. Spearman's rank correlation was used to assess the relationship between functional outcome or cosmetic results and preoperative variables including duration of clinical signs, digital sheath synovial fluid total protein concentration and nucleated cell count, thickness of the palmar or plantar proximal annular ligament (PAL), severity of adhesions, severity of synovial masses, degree of synovial distention, or limb affected. RESULTS: A total of 18 (72%) horses returned to athletic soundness, 4 were improved but not sound, and 3 were not improved. Cosmetic outcome was normal in 10 horses, improved but not normal in 12, and not improved in 3 horses. Cosmetic and functional outcome were significantly adversely affected by the duration of clinical signs and the severity of synovial masses. CONCLUSIONS: With appropriate tenoscopic surgical attention, horses with complex tenosynovitis syndrome characterized by synovial masses, adhesions, or both adhesions and masses, and PAL constriction, have a good prognosis for return to athletic soundness. CLINICAL RELEVANCE: Horses with PAL constriction and additional digital tendon sheath pathology such as adhesions and synovial masses have a 72% chance of returning to sound athletic performance, however 60% of horses retain some degree of cosmetic blemish in the affected limb. There is an inverse relationship between the duration of clinical signs and outcome, and therefore, prompt surgical attention is advised.  相似文献   

8.
Physical, biochemical, and cytologic properties of synovial fluid from digital flexor tendon sheaths of clinically normal horses were investigated. Tendon sheath fluid was pale yellow, clear, and did not clot. Volume of fluid within a tendon sheath varied minimally, with a mean of 2.11 ml. Total erythrocyte counts were higher than values observed in normal equine joint fluid, whereas values for total leukocyte count (770 +/- 73 cells/mm3), viscosity (6.05 +/- 0.58 cs), and protein concentration (7.87 +/- 0.03 mg/ml) were similar to those in joint fluid. Large mononuclear cells were the predominant synovial fluid cell type. Mean hyaluronic acid concentration (0.74 +/- 0.02 mg/ml) and mucinous precipitate quality were lower than values in joint fluid.  相似文献   

9.
This paper reports the diagnosis and repair of synovial fistulae between a carpal hygroma and both the antebrachiocarpal (ABC) joint and the extensor carpi radialis (ECR) tendon sheath of the left carpus in a 7-year-old gelding. The communication was confirmed using contrast radiography. Arthroscopy visualised the synovial fistulae and aided in the surgical repair. The gelding made a full athletic and acceptable cosmetic recovery.  相似文献   

10.
Although ovine stifle models are commonly used to study osteoarthritis, meniscal pathology and cruciate ligament injuries and repair, there is little information about the anatomy of the joint or techniques for synovial injections. The objectives of this study were to improve anatomical knowledge of the synovial cavities of the ovine knee and to compare intra-articular injection techniques. Synovial cavities of 24 cadaver hind limbs from 12 adult sheep were investigated by intra-articular resin, positive-contrast arthrography, computed tomography (CT) arthrography and gross anatomical dissection. Communication between femoro-patellar, medial femoro-tibial and lateral femoro-tibial compartments occurred in all cases. The knee joint should be considered as one synovial structure with three communicating compartments. Several unreported features were observed, including a communication between the medial femoro-tibial and lateral femoro-tibial compartments and a latero-caudal recess of the lateral femoro-tibial compartment. No intermeniscal ligament was identified. CT was able to define many anatomical features of the stifle, including the anatomy of the tendinous synovial recess on the lateral aspect of the proximal tibia under the combined tendon of the peroneus tertius, extensor longus digitorum and extensor digiti III proprius. An approach for intra-articular injection into this recess (the subtendinous technique) was assessed and compared with the retropatellar and paraligamentous techniques. All three injection procedures were equally successful, but the subtendinous technique appeared to be most appropriate for synoviocentesis and for injections in therapeutic research protocols with less risk of damaging the articular cartilage.  相似文献   

11.
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   

12.
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   

13.
Objective— To report the use of a proximolateral endoscopic portal with a distolateral instrument portal for carpal retinaculum release in a horse clinically affected with carpal canal syndrome. Study Design— Clinical report. Animals— A 4‐year‐old Thoroughbred female. Methods— Carpal canal syndrome secondary to traumatic suppurative tenosynovitis was treated by accessory carpal bone debridement and carpal retinaculum release using a tenoscopic approach to the carpal flexor synovial sheath through a proximolateral endoscope portal and a distolateral instrument portal. Results— Resolution of carpal sheath effusion and lameness occurred allowing racing 14 months later. Use of a distolateral instrument portal was not associated with complications or iatrogenic damage to neurovascular structures and reduced endoscope and instrument interference and offered easier access to the distal aspect of the carpal sheath. Conclusions— Carpal retinaculum release may be safely accomplished with a distolateral instrument portal when access to the distal aspect of the carpal sheath is needed. Clinical Relevance— The distolateral instrument portal described may be a useful alternative to a proximolateral portal when distal carpal sheath instrument access is necessary or advantageous.  相似文献   

14.
Equine mast cell tumours (MCT) have been reported to occur in the skin, respiratory tract, oral cavity, synovial structures and eye. These tumours are typically locally invasive and nonaggressive. In this case, a MCT was located in the extensor carpi radialis (ECR) and was highly infiltrative. Excision of the ECR and local corticosteroid injection was curative and resulted in a good functional outcome. A 12-year-old Thoroughbred gelding presented for lameness, swelling and pruritus associated with the right antebrachium. Sonographic changes were suggestive of severe tenosynovitis and purulent material in the ECR. Surgical exploration revealed maceration at the ECR musculotendinous junction. The extensor sheath contained a large quantity of caseous material and serosanguinous fluid. The ECR tendon and 75% of the muscle was excised. Cytology and histopathology were consistent with a MCT that infiltrated the surgical margins. Post-operatively the horse was treated with multiple local corticosteroid injections along the incision. Right forelimb movement was initially limited, however, there was steady improvement over 3 months with increasing exercise. At 18 months post-operatively, no lameness was detectable in the walk, trot or canter and no recurrence of MCT was apparent. The horse appeared to compensate for loss of the ECR by using the biceps during the swing phase. Partial excision and local corticosteroid treatment can be curative for cases of invasive MCT. Extensive excision of the ECR is a viable treatment option for neoplasia or other conditions affecting the ECR in the horse.  相似文献   

15.
AIM: To investigate the presence of surface-active phospholipid (SAPL, or surfactant) in equine tendon and tendon sheath fluid. METHODS: The left front flexor tendon and sheath were removed from five Thoroughbred horses. Phospholipid was extracted from tendon sheath fluid using Folch reagent and quantified using spectroscopy. Transmission electron microscopy (TEM) was used to observe the tendon surfaces. RESULTS: The presence of phospholipid (90.6 (SD 4.3) microg/ml) in tendon sheath fluid, plus the appearance of oligolamellar layers and lamellar bodies on the tendon surface were indicative of SAPL. CONCLUSIONS: Evidence of SAPL was found in equine tendon, and may have a similar lubricating function as reported for synovial joints. CLINICAL RELEVANCE: These findings may have important implications for normal tendon function and possible therapeutic adjuncts for tendon and tendon sheath injuries.  相似文献   

16.
A four-year-old gelding was lame owing to a chronic septic common digital extensor tendon and sheath. The horse had been treated by open surgical lavage but the sepsis had recurred after three months. Physical, ultrasonographic, cytological and histological examinations confirmed chronic septic tenosynovitis and tendonitis. The entire intrathecal component of the common digital extensor tendon was resected under general anaesthesia and the synovial lining of the sheath was ablated. Postoperatively the horse regained good limb function and became sound.  相似文献   

17.
This case report describes surgical treatment of 3 cases of septic chronic tenosynovitis of the tarsal sheath with fragmentation of the sustentaculum tali in 3 horses. Diagnosis was based on clinical signs, radiographic and ultrasonographic findings, synovial fluid cytology, and bacteriology. In each case, treatment consisted of tenovaginoscopy of the tarsal sheath performed with the horse under general anesthesia and regional intravenous perfusion of antibiotics. Follow-up data obtained between 12 and 46 months after surgery reported a good outcome, with a good cosmetic appearance in all cases described. Two horses returned to their intended use at 44 and 46 months, and 1 horse reportedly showed a remarkable functional improvement after 12 months. Despite the poor prognosis associated with the chronicity of the lesions, the presence of adhesions and the degree of involvement of the lateral digital flexor tendon, tenovaginoscopy of the tarsal sheath and regional antimicrobial therapy were successful therapeutic options for treating septic tenosynovitis of the tarsal sheath with fragmentation of the sustentaculum tali.  相似文献   

18.
AIM: To investigate the presence of surface-active phospholipid (SAPL, or surfactant) in equine tendon and tendon sheath fluid.

METHODS: The left front flexor tendon and sheath were removed from five Thoroughbred horses. Phospholipid was extracted from tendon sheath fluid using Folch reagent and quantifi ed using spectroscopy. Transmission electron microscopy (TEM) was used to observe the tendon surfaces.

RESULTS: The presence of phospholipid (90.6 (SD 4.3) μg/ml) in tendon sheath fluid, plus the appearance of oligolamellar layers and lamellar bodies on the tendon surface were indicative of SAPL.

CONCLUSIONS: Evidence of SAPL was found in equine tendon, and may have a similar lubricating function as reported for synovial joints.

CLINICAL RELEVANCE: These findings may have important implications for normal tendon function and possible therapeutic adjuncts for tendon and tendon sheath injuries.  相似文献   

19.
The aim of this study is to describe the successful treatment of a synovial hernia associated with the digital flexor tendon sheath (DFTS) in a 17-year-old pony. The pony presented with left forelimb lameness and multiple unusual swellings of the palmar and plantar aspect of the fetlock. The lameness was isolated to a swelling in close proximity to the DFTS of the left forelimb using diagnostic analgesia, and on diagnostic imaging, the swelling was found to be associated with the DFTS. The hernia resolved after percutaneous drainage and intralesional corticosteroids and atropine and pressure bandaging. Reports of synovial hernias in the horse associated with the DFTS are rare. This difference should be considered when presented with cases exhibiting similar clinical signs.  相似文献   

20.
Objectives: To evaluate digital flexor tendon sheath (DFTS) synovial fluid cartilage oligomeric matrix protein (COMP) concentrations as a molecular marker for intrathecal pathology. Study Design: Case control study. Animals: Horses (n=46) with DFTS tenosynovitis; 23 fresh cadaver horses. Methods: DFTS synovial fluid samples were collected from clinical cases with noninfected DFTS tenosynovitis and from control DFTS. Clinical and surgical findings were recorded, and dissection of control limbs was performed to confirm the DFTS to be grossly normal. Synovial fluid COMP was quantified using a homologous competitive inhibition ELISA. Results: Abnormalities were identified tenoscopically: intrathecal tendon/ligament tearing was identified in 37 cases and 9 had other lesions. In control horses, synovial fluid COMP was higher in younger horses. Clinical cases with intrathecal tendon/ligament tearing had higher synovial fluid COMP than either clinical cases with other lesions, or controls. In horses ≥5 years old, the sensitivity and specificity of the assay was high for diagnosing intrathecal tendon/ligament tearing. Conclusions: COMP concentrations in DFTS synovial fluid were significantly greater than those in normal horses with noninfected tenosynovitis caused by intrathecal tendon/ligament tearing, but not by other lesions.  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