Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
EqMed-Hock/Stifle
Exam 2 Review of Hock and Stifle Lameness-Keegan
| Question | Answer |
|---|---|
| What term refers to lameness of the hock that manifests itself via radiographic changes of the joint? | Bone spavin |
| What term refers to degenerative joint disease in the lower three distal joints of the equine hindlimb? | Spavin |
| Which two joints in the lower hindlimb of equids can commonly communicate? | Distal intertarsal and tarsometatarsal |
| Which joint in the equine lower hindlimb will have the most serious prognosis when affected by "spavin"? | Proximal intertarsal joint (occurs less frequently in this joint though) |
| What is Jack spavin and where does it manifest? | Lameness due to inflammation originating in the cunean tendon and bursa |
| What type of spavin of the hock causes lameness without the appearance of radiographic changes? | Blind spavin |
| What is a common cause of Juvenile spavin in young horses? | Osteochondrosis |
| What are two conformations of the equine hindlimb that might predispose to development of spavin in the hock? | "Cow" hock (bowing of the leg out) or "Sickle" hock (from lateral view, the hock is bent more and resembles a sickle) |
| What type of working horses are more predisposed to the development of spavin in the hock? | Working western horses (roping, cutting, etc...) and horses that pull loads |
| What is it about western horse work that can cause formation of spavin of the hock? | Compression of the dorsal cortex of the metatarsal bones/lower hindlimb bones |
| What type of stress is put on the hindlimb of a horse that pulls loads, like a racing standardbred, that can lead to spavin? | shear stress on the lower leg (resistance on the caudal part and propelling force on the dorsal part of the lower leg) |
| What type of horse shoes can predispose to formation of spavin and for what reason? | Caulks, Grabs and Trailers - cause the foot to "brake" = too much traction? |
| Over the progression of disease, what causes horses with spavin to eventually "get better"? | Fusion of the affected joint |
| What are the characteristics of lameness due to spavin of the hock? | limb swings medially, increased flexion of the hock, shortened protraction, and lands on the outside hoof wall (none of these are just specific to spavin) |
| What is the result of a positive Churchill test and how is it administered? | Squeezing the area of the hock - if positive, means the horse reacted by abducting the leg laterally |
| What is the technique of a "Spavin test" and what signifies a positive result? | flexion of the pelvic limb for 60-90 secs - if positive then there will be increased lameness and hypermetria during trotting |
| What is the best diagnostic method for spavin of the hock? | Administering intra-articular anesthesia to block both the distal intertarsal and tarsometatarsal joints - if the lameness goes away, then have spavin |
| What is important to recognize about the radiographic signs associated with spavin of the hock? | They may not correlate to severity of lameness - horse could have minimal radiographic changes with severe lameness and vice versa |
| What type of exercise can serve as treatment for spavin? | Frequent exercise/turnout with long, slow work |
| What are the characteristics of corrective shoeing for treatment of spavin? | Raise the heel, shorten the toe, use flat plates, cause breakover at the medial toe |
| What are two types of medical therapy used during treatment of spavin? | NSAIDs and intra-articular injections with steroids or Hyaluronic acid |
| What is IRAP and what are its effects upon intra-articular injection into the hock for spavin treatment? | =Interleukin receptor antagonist protein; blocks binding of IL-1 to receptors and prevents the breakdown of cartilage |
| What tendon can be removed in the treatment of "jack" spavin? | Cunean tendon = tenectomy |
| What is the "last resort" treatment for spavin of the hock? | Surgical arthodesis - fusion of the hock joint |
| What joint is affected by "Bog" spavin? | Tibiotarsal joint |
| What are the four potential causes of bog spavin in a horse? | Osteochondrosis (young), Trauma, Sepsis, or Idiopathic |
| What are the characteristics of idiopathic bog spavin? | Doesn't have any lameness or radiographic signs - just the effusion of the joint - though maybe nutritional or due to rapid growth |
| Swelling of the hock due to bog spavin is most common manifest on which surface of the leg? | Dorsomedial surface = most prominent |
| What potential cause of bog spavin will result in the most severe lameness? | Due to sepsis of the joint (hematogenous or iatrogenic) |
| What potential cause of bog spavin will result in the least severe signs of lameness? | Osteochondrosis (none to mild) |
| What is the incidence of bilateral effusion of the joint from bog spavin? | 28-56% will have bilateral effusion |
| What are the most common sites for lesions in the hock joints due to bog spavin? | Distal intermediate ridge of tibia, medial malleolus, and lateral trochlear ridge |
| T/F Negative radiographs for lesions can rule out osteochondrosis as a cause of bog spavin. | False - often not noticed and then seen later with arthroscopy |
| Synovial fluid analysis is helpful in diagnosing what two forms/causes of bog spavin? | Hemarthrosis due to trauma and sepsis (will have high protein and TNCC) |
| Scintigraphy is not very useful for diagnosing bog spavin that is due to what cause and why? | Osteochondrosis - because it occurs in young horses which have "hot" physes that will obscure the lesions |
| What is the treatment for bog spavin that is caused by osteochondrosis? | Arthroscopic surgery |
| What are the treatments for bog spavin that is caused by sepsis? | Antibiotics, flushing the joint, and hyaluronic acid |
| What are the treatments for bog spavin that is caused by trauma to the joint? | Rest, medical treatment (pain relief, steroids), may perform surgery if there are bone fragments |
| What is the treatment for idiopathic bog spavin? | Don't do anything until starts causing a problem |
| What two types of bog spavin will have the best prognosis for treatment? | Idiopathic (soundness = good) and osteochondrosis (fair to excellent with surgery) |
| If there is a luxation in the distal tarsal joints, what is the prognosis and treatment? | Fairly good, just have to realign and support the luxation; not much movement there anyway |
| Luxation of the tibiotarsal joint will have what prognosis and why? | Usually euthanasia is performed, b/c luxation only occurs with very severe injury to ligaments |
| What is curb and what is the cause of it? | Inflammation of the plantar ligament due to violent over-extension of the hock or blunt trauma |
| Where is the plantar ligament anatomically? | runs down the back of the calcaneus bone |
| What horses most commonly get curb in the hock? | Racing standardbreds |
| How is diagnosis of Curb normally made? | visual or palpation - see enlargement of the plantar surface of the calcaneus |
| What occurs during chronic curb in the hock? | Occurs during exertion, then goes away when rested, comes back when exertion, etc... in that cycle |
| What is the reaction of the horse to acute curb in the hock during walking? | Reluctant to put the heel down - because will extend the calcaneus ligament |
| What is the purpose of cold therapy in acute cases of curb? | To reduce the inflammation and allow blood flow to continue, in order to lessen damage --> has to be done immediately |
| What is a problem with corticosteroid injections into the plantar ligament during acute curb? | Can cause the horse to feel better and may cause it to be damaged more severely as a result of not feeling as much pain |
| Ligment/tendon injuries should almost always be initially treated with what technique? | Rest for short time and then gradually increasing intensity and duration of activity |
| What diagnostic step is important for cases of acute curb that are caused by trauma? | Radiographs to rule out the formation of sequestra or periosteal response on the plantar aspect of the calcaneus or MT4 |
| What is the effect of DMSO rubs on an acute case of curb? | reduces the amount of inflammation |
| What is the main problem with chronic curb and treatment? | Fibrosis of the tendon makes it difficult to treat |
| What is the main treatment for chronic cases of curb? | Pain relief and resting of the horse |
| What is the prognosis for a horse with curb? | Good if they have normal conformation, but the ligament will often remain enlarged and thickened even though not lamed |
| What is capped hock and how is it caused? | formation of a hygroma over the point of the hock and SDF tendon - usually caused by trauma |
| What is the main differential diagnosis for capped hock? | Luxation of the SDF tendon |
| What type of lameness is caused by capped hock in a horse? | Doesn't usually cause lameness unless there is damage to the SDF tendon |
| What other type of injury can be seen simultaneously to capped hock? | Curb - both are caused by the same thing |
| What should always be checked in the horse that is diagnosed with capped hock before treating for that condition? | Should always check for luxation of the SDF tendon |
| What is the best treatment for capped hock? | Best to do nothing but rest the horse |
| What should never be done in the treatment of capped hock? | shouldn't ever perform surgical resection unless a serious problem because of the complications and having to put in a full-limb cast |
| What is the prognosis for capped hock? | Excellent - usually just with rest; might not look good b/c some don't go away but the leg will work |
| What is the cause of a luxated SDF tendon? | rupture of the supporting tissues that maintain the SDF over the point of the hock |
| What is a differentiating clinical sign between capped hock and luxation of the SDF tendon? | With luxation, the horse will usually be very lame and can see the tendon come off the point of the hock during exercise |
| What is thoroughpin and what is the usually cause? | Effusion of the tarsal sheath (DDF tendon runs through it)due to extreme dorsiflexion of the hock or puncture wounds, idiopathic, or masses |
| What is the treatment for SDF tendon luxation? | Surgery - very difficult and have to immobilize the leg with a cast so potential for complications |
| What is the most important aspect of thoroughpin that needs to be checked for damage? | DDF tendon damage |
| Involvement of what structure should be ruled out during a radiographic diagnosis of thoroughpin? | Involvement/puncture of the sustentaculum tali (makes up part of the tarsal sheath and if punctured, could cause damage to the DDFT) |
| What should be done to treat a case of thoroughpin if the sustentaculum tali is affected? | Surgical removal of any sequestra or dead bone |
| What type of thoroughpin has a generally poor prognosis and why? | Trauma/sepsis causes - because can have residual lameness in the horse if there are adhesions on the DDFT |
| What is the origin and insertion for the peroneus tertius? | femur and the cannon bone = ligamentous structure |
| What is characteristic of an injury to the peroneus tertius ligament? | Severe lameness acutely with leg hanging limp when advacing (just swinging loose), but the animal has no difficulty weight bearing on the leg, not easy to elicit pain on palpation |
| What is a physical exam finding that is diagnostic for injury to the peroneus tertius? | Ability to extend the hock while the stifle is flexed - shouldn't be able to do that |
| What is distinctive about the lameness caused by injury to the Peroneus tertius? | very "mechanical" or robotic appearance to the lameness |
| What is the treatement for peroneus tertius injury and how is the prognosis? | Rest - prognosis is fair to guarded; bad if doesn't resolve in 4-6 weeks |
| What is stringhalt and what is the cause? | Involuntary or exaggerated flexion of the hindlimb that is caused by a neurologic problem (reflex arc) |
| Which form of stringhalt is bilateral, epidemic, and due to toxins? | the "Australian" form |
| Which form of stringhalt is unilateral, sporadic, and due to trauma? | "Classic" form |
| What is the cause of "False" stringhalt? | severe pain at impact of the foot or upon weight-bearing |
| What is the etiology for classic stringhalt? | Trauma to the dorsal aspect of the metatarsus or tarsus |
| What is the treatment for the classical form of stringhalt? | Lateral Digital Extensor tenectomy - very easy to do and effective |
| What two drugs can be used to treat stringhalt? | Mephenesin (muscle relaxant) and phenytoin (anticonvulsant) |
| What is the prognosis for unilateral stringhalt (classic form) after lateral digital extensor tenectomy? | Good if take off enough of the ligament = if doesn't help then take off more |
| What term refers to inflammation of the stifle joint? | Gonitis |
| What are the most common sites for osteochondrosis lesions in the stifle? | Lateral trochlear ridge, medial femoral condyle (cyst), and the undersurface of the patella |
| What are some causes of stifle lameness from the soft tissue? | Fracture of medial eminence (cruciate injury), collateral ligaments, and meniscal tears can all cause gonitis |
| What is a radiographic sign of soft tissue injury in the stifle that can lead to lameness? | Mineralization/calcification = usually don't see until months after the lesion so not reliable |
| What is the biggest cause of gonitis in neonates? | Joint ill/septicemia causing infection of the joint |
| What is the most commonly seen cause of stifle lameness in the horse? | Osteochondrosis ~ 50% of lameness b/t medial condylar cysts (38%) and lateral trochlear ridge lesions (13%) |
| How severe is the stifle lameness that is seen from osteochondrosis? | Mild to moderate lameness |
| What is the appearance of the limb movements associated with gonitis? | abduction of the limb during the swing phase of the stride (brings the leg medially) - Dr. Keegan doesn't think this is characteristic though |
| What should be done when radiographing the stifle to look for osteochondrosis lesions? | Bilateral radiographs because over half are bilateral and can often see in subclinical lameness of the off leg (before the other leg goes lame) |
| What radiographic view is best for examining the patella and trochlear ridges for osteochondrosis lesions? | Flexed lateral view (not sure about the flexed part, just assuming) |
| What radiographic view is best to look for distal femoral cysts associated with osteochondrosis of the stifle joint? | Anterior posterior view |
| What is the treatment for gonitis that is caused by osteochondrosis? | Arthroscopic surgery - remove cystic contents and stimulate bone growth |
| What is the prognosis for osteochondrosis caused gonitis in the lateral trochlear ridge and patella? | Good, and the smaller the lesions, the better it is (>70%) |
| What is the prognosis for medial femoral cysts that are treated in stifle lameness? | Good with surgery, although 25% get worse with the surgery |
| What are the outcomes for lameness caused by the different types of patellar fractures? | Very poor for comminuted, fair to good for small pieces of articular bone, |
| What two conditions causing lameness of the stifle have a poor prognosis? | Degenerative joint disease and sepsis |
| What are the potential causes of upward fixation of the patella in a horse? | Poor quadriceps muscle tone due to inactivity or neurologic disease, Stretched patellar ligaments, Upright limb conformation |
| What horse breed commonly gets upward fixation of the patella? | Shetland ponies |
| What is the best treatment for intermittent upward fixation of the patella? | Exercise - most cases will resolve with just this |
| Injury to any of what three structures can result in fibrotic myopathy? | semimembranosus, semitendinosis, and biceps femoris |
| What are methods of diagnosis for fibrotic myopathy? | Palpation of posterior stifle, observation of rapid caudal jerking of the limb right before contacting the ground (at a walk) |
| What is the best treatment for fibrotic myopathy in a leisure horse that isn't affected very much by the mass? | leave it alone until it affects performance |
| What are the clinical signs of pelvic fractures in a horse? | Acute severe lameness, no swelling, if acetabulum isn't involved then will improve significantly over time, gluteal muscle atrophy 2 months after surgery |
| What is the treatment for a fractured pelvis? | Stall rest, surgery not indicated normally |
| When is the prognosis for a fractured pelvis good? | If fractured tuber coxae, there will be visual deformity though |
| What type of pelvic fracture has a poor prognosis? | If the acetabulum is involved |
| What are the treatments for fractures of the dorsal spinous processes in a horse? | Rest and refrain from saddle use for a long time |
| What horses are at a greater risk for developing overriding dorsal spinous processes? | Dressage and jumping horses - because have extreme back extension |
| What type of joint is the sacroiliac joint? | Fibrous - makes it easier to subluxate |
| What are Hunter's Bumps? | hypertrophy of the sacroiliac fibrous joint |
| What is a physical sign of sacroiliac luxation? | Asymmetry in the height of the tuber sacrale |
| What is a physical sign of Hunter's bumps? | hypertrophy of the tuber sacral area |
| What is the prognosis for injury to the sacroiliac joint? | Fair to good for soundness but will always look abnormal and be prone to reinjury |
| What is the treatment for SI subluxation and hunter's bumps? | Initially rest, and then slow rebuilding of the gluteal muscles |
Created by:
mattsboone