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Equine Orthopaedics and Rheumatology Q&A 07 (view source)
Revision as of 10:21, 27 May 2011
, 10:21, 27 May 2011Created page with "{{Template:Manson May}} centre|500px<br> <br /> '''An eight-year-old Thoroughbred gelding presented with a right fore..."
{{Template:Manson May}}
[[Image:Equine Orthopaedics and Rheumatology Q&A 07.jpg|centre|500px]]<br>
<br />
'''An eight-year-old Thoroughbred gelding presented with a right forelimb lameness, grade 2/5 at the trot, of eight weeks duration. The lameness was insidious in onset, did not improve with rest or exercise, and was the same on any surface.'''
<br />
<FlashCard questions="4">
|q1=What abnormal features of the right forelimb can be recognised in the image?
|a1=There is marked distension of the digital sheath on the palmar aspect of the fetlock. The distal end of the swelling has a notched appearance. The horse has a slightly broken back hoof–pastern axis and low heels.
|l1=
|q2=From the history and clinical signs, what causes of lameness would you consider?
|a2=
*Annular ligament syndrome is the most obvious possibility.
*Superficial or deep digital flexor tendon injuries.
*Previous penetrating wounds into the sheath, may be contributing factors. <br><br>
But in view of the poor foot conformation, a foot problem should also be considered as the cause of the lameness, since these digital sheath swellings are not always painful.
|l2=
|q3=What further tests would you perform to confirm your diagnosis?
|a3= Intrasynovial analgesia of the digital sheath will not always abolish the lameness, presumably because of adhesions or the mechanical influence of the constricted annular ligament.
*Analgesia of the palmar nerves proximal to the fetlock is usually effective.
*Ultrasonography is important for evaluation of the annular ligament and the flexor tendons, and may indicate the presence of adhesions.
*Regional analgesia of the foot should be performed to ensure that foot pain is not involved.
|l3=
|q4= How would you treat this case?
|a4= Acute cases should be treated with rest, possibly combined with both topical and systemic anti-inflammatory drug therapy. If this fails, an annular ligament desmotomy is indicated.
|l4=
</FlashCard>
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[[Category:Equine Orthopaedics and Rheumatology Q&A]]
[[Image:Equine Orthopaedics and Rheumatology Q&A 07.jpg|centre|500px]]<br>
<br />
'''An eight-year-old Thoroughbred gelding presented with a right forelimb lameness, grade 2/5 at the trot, of eight weeks duration. The lameness was insidious in onset, did not improve with rest or exercise, and was the same on any surface.'''
<br />
<FlashCard questions="4">
|q1=What abnormal features of the right forelimb can be recognised in the image?
|a1=There is marked distension of the digital sheath on the palmar aspect of the fetlock. The distal end of the swelling has a notched appearance. The horse has a slightly broken back hoof–pastern axis and low heels.
|l1=
|q2=From the history and clinical signs, what causes of lameness would you consider?
|a2=
*Annular ligament syndrome is the most obvious possibility.
*Superficial or deep digital flexor tendon injuries.
*Previous penetrating wounds into the sheath, may be contributing factors. <br><br>
But in view of the poor foot conformation, a foot problem should also be considered as the cause of the lameness, since these digital sheath swellings are not always painful.
|l2=
|q3=What further tests would you perform to confirm your diagnosis?
|a3= Intrasynovial analgesia of the digital sheath will not always abolish the lameness, presumably because of adhesions or the mechanical influence of the constricted annular ligament.
*Analgesia of the palmar nerves proximal to the fetlock is usually effective.
*Ultrasonography is important for evaluation of the annular ligament and the flexor tendons, and may indicate the presence of adhesions.
*Regional analgesia of the foot should be performed to ensure that foot pain is not involved.
|l3=
|q4= How would you treat this case?
|a4= Acute cases should be treated with rest, possibly combined with both topical and systemic anti-inflammatory drug therapy. If this fails, an annular ligament desmotomy is indicated.
|l4=
</FlashCard>
{{#tag:imagemap|Image:Next Question.png{{!}}center{{!}}200px
rect 0 0 860 850 [[Equine Orthopaedics and Rheumatology Q&A 08|Next question]]
desc none}}
[[Category:Equine Orthopaedics and Rheumatology Q&A]]