Changes

|q1= Describe the investigation which has been undertaken to produce the picture illustrated in the radiograph.

|q1= Describe the investigation which has been undertaken to produce the picture illustrated in the radiograph.

|a1= This is a contrast radiograph. A catheter, introduced into the puncture wound near the heel, has been advanced as far as possible, and a contrast agent injected. This has filled the digital sheath.

|a1= This is a contrast radiograph. A catheter, introduced into the puncture wound near the heel, has been advanced as far as possible, and a contrast agent injected. This has filled the digital sheath.

|l1=

|l1=Contrast Radiography

|q2=What is the likely explanation for the deterioration in the horse’s condition?

|q2=What is the likely explanation for the deterioration in the horse’s condition?

|a2=The nail has penetrated and contaminated the digital sheath. The severe lameness was associated with an infective tenosynovitis.

|a2=The nail has penetrated and contaminated the digital sheath. The severe lameness was associated with an infective tenosynovitis.

|l2=

|l2=Tenosynovitis

|q3=How could you confirm this?

|q3=How could you confirm this?

|a3=  

|a3=  

Synoviocentesis: <br>

Synoviocentesis: <br>

The gross appearance might suggest infection. Failing that, and in addition, the sample should be submitted for a total nucleated cell count, measurement of total protein concentration and bacterial culture.

The gross appearance might suggest infection. Failing that, and in addition, the sample should be submitted for a total nucleated cell count, measurement of total protein concentration and bacterial culture.

|l3=

|l3=Tenosynovitis

|q4=What treatment would you recommend?

|q4=What treatment would you recommend?

|a4=  

|a4=  

*Lavage of the digital sheath with several litres of sterile, balanced electrolyte solution. *Systemic broad-spectrum antibiotic therapy, until this can be modified according to the antibacterial sensitivity of any organisms cultured.  

*Lavage of the digital sheath with several litres of sterile, balanced electrolyte solution.  

*Systemic broad-spectrum antibiotic therapy, until this can be modified according to the antibacterial sensitivity of any organisms cultured.  

*Non-steroidal anti-inflammatory drug therapy.  

*Non-steroidal anti-inflammatory drug therapy.  

*Intrasynovial antibiosis might also be used. <br>

*Intrasynovial antibiosis might also be used. <br>

This case rapidly improved after flushing, and returned to soundness.

This case rapidly improved after flushing, and returned to soundness.

|l4=

|l4=Tenosynovitis

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