Difference between revisions of "Quittor"

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Also Known As '''''Phalangeal cartilage necrosis – Lateral cartilage necrosis - Third Phalanx cartilage necrosis – Distal phalanx cartilage necrosis – Subcoronary abscess – Coronary sinus injury'''''
Also Known As: '''''Phalangeal Cartilage Necrosis — Lateral Cartilage Necrosis — Third Phalanx Cartilage Necrosis — Distal Phalanx Cartilage Necrosis — Subcoronary Abscess — Coronary Sinus Injury'''''
 
  
 
==Introduction==
 
==Introduction==
Quittor is a '''chronic, purulent inflammatory disease of the lateral cartilages of the [[Phalanges - Horse Anatomy#Distal Phalanx|third (distal) phalanx]].'''
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Quittor is a '''chronic, purulent inflammatory disease of the lateral cartilages of the [[Equine Phalanges - Anatomy & Physiology|third (distal) phalanx]].'''
  
 
Infection of the cartilage is '''caused by injury to the coronet, sole, heel or pastern regions''', allowing deep introduction of infection. This causes '''abscesses to form and sinus tracts''' to extend from the diseased cartilage, breaking through the '''skin in the coronary region.'''
 
Infection of the cartilage is '''caused by injury to the coronet, sole, heel or pastern regions''', allowing deep introduction of infection. This causes '''abscesses to form and sinus tracts''' to extend from the diseased cartilage, breaking through the '''skin in the coronary region.'''
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==Clinical Signs==
 
==Clinical Signs==
The first sign of quittor is '''inflammation and swelling over the alar cartilage'''. The consequent abscess may be visible or pain may be exhibited on palpation of the area. Quantity of '''purulent discharge''' varies, so may only be detectable as '''matting of the hair or may stream freely down the hoof.'''
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The first sign of quittor is '''inflammation and swelling over the alar cartilage'''. The consequent abscess may be visible or pain may be exhibited on palpation of the area. Quantity of ''purulent discharge''' varies, so may only be detectable as '''matting of the hair or may stream freely down the hoof.'''
  
[[Lameness - Horse|Lameness]] occurs during the acute stage of disease although both '''pain and lameness may be intermittent''', particularly early in disease progression.
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Lameness occurs during the acute stage of disease although both '''pain and lameness may be intermittent''', particularly early in disease progression.
  
 
Without treatment, infection, abscessation and necrosis will extend to deeper structures and prognosis is grave.
 
Without treatment, infection, abscessation and necrosis will extend to deeper structures and prognosis is grave.
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'''Antibiotics and specialised dressings''' such as those impregnated with '''silver''' may assist more rapid healing.
 
'''Antibiotics and specialised dressings''' such as those impregnated with '''silver''' may assist more rapid healing.
  
Early lesions treated aggressively often respond well but involvement of the coronary band or joint capsule and chronic lesions carry a poor prognosis.
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Early lesions treated aggressively often respond well but involvement of the coronary band or joint capsule involvement and chronic lesions carry a poor prognosis.
  
 
{{Learning
 
{{Learning
 
|flashcards = [[Quittor Flashcards]]
 
|flashcards = [[Quittor Flashcards]]
 
[[Equine Orthopaedics and Rheumatology Q&A 20]]
 
 
}}
 
}}
  
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Merck Veterinary Manual, '''Quittor''', accessed online 24/07/2011 at http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/90727.htm
 
Merck Veterinary Manual, '''Quittor''', accessed online 24/07/2011 at http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/90727.htm
  
 
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[[Category:To Do - Manson review]] [[Category: Musculoskeletal Diseases - Horse]]
{{review}}
 
 
 
{{OpenPages}}
 
 
 
[[Category:Expert Review - Horse]] [[Category: Musculoskeletal Diseases - Horse]]
 

Revision as of 12:23, 26 July 2011

Also Known As – Phalangeal cartilage necrosis – Lateral cartilage necrosis - Third Phalanx cartilage necrosis – Distal phalanx cartilage necrosis – Subcoronary abscess – Coronary sinus injury

Introduction

Quittor is a chronic, purulent inflammatory disease of the lateral cartilages of the third (distal) phalanx.

Infection of the cartilage is caused by injury to the coronet, sole, heel or pastern regions, allowing deep introduction of infection. This causes abscesses to form and sinus tracts to extend from the diseased cartilage, breaking through the skin in the coronary region.

Distribution

Quittor is now rare.

Signalment

Quittor was historically common in working draft horses.

Clinical Signs

The first sign of quittor is inflammation and swelling over the alar cartilage'. The consequent abscess may be visible or pain may be exhibited on palpation of the area. Quantity of purulent discharge varies, so may only be detectable as matting of the hair or may stream freely down the hoof.

Lameness occurs during the acute stage of disease although both pain and lameness may be intermittent, particularly early in disease progression.

Without treatment, infection, abscessation and necrosis will extend to deeper structures and prognosis is grave.

Diagnosis

Diagnosis is often based on clinical signs, history of injury to relevant areas and the absence of any other cause of lameness.

Plain and contrast radiography will assist in assessing the extent of the damage.

MRI and CT imaging may be diagnostic if available.

Diagnosis is often confirmed at surgery.

Treatment

Surgery is required to remove the diseased tissue and all infected cartilage under general anaesthesia.

Antibiotics and specialised dressings such as those impregnated with silver may assist more rapid healing.

Early lesions treated aggressively often respond well but involvement of the coronary band or joint capsule involvement and chronic lesions carry a poor prognosis.


Quittor Learning Resources
FlashcardsFlashcards logo.png
Flashcards
Test your knowledge using flashcard type questions
Quittor Flashcards


References

Knottenbelt, D. C., McGarry, J. W (2009) Pascoe’s Principles & Practice of Equine Dermatology 2nd ed. Elsevier, UK, 372-373.

Merck Veterinary Manual, Quittor, accessed online 24/07/2011 at http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/90727.htm