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| | * 13 year old, Anglo-Arab Gelding, weighing 559kg. | | * 13 year old, Anglo-Arab Gelding, weighing 559kg. |
| | * He presented with an intermittent right forelimb lameness of 2 -3 month duration. | | * He presented with an intermittent right forelimb lameness of 2 -3 month duration. |
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| − | ==What would your work up now consist of?==
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| − | There are 6 things that could be done to achieve a full work up.... (highlight to reveal answers)
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| − | <font color="white">
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| − | * Further history
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| − | * Physical Examination
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| − | * Gait Analysis
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| − | * Diagnostic Analgesia
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| − | * Radiographs or Ultrasounds
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| − | * Scintigraphy
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| − | </font>
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| − | ==Clinical Examination Results==
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| − | '''A link could be put in here to show you have to perform a clinical exam on a horse'''
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| − | * Forelimb palpation:
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| − | ** Right Forlimb:
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| − | *** heat and swelling at proximal metacarpal region
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| − | *** mild pain elicited on suspensory ligament palpation
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| − | *** mild thickening of lateral branch of SL (no pain)
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| − | * Hoof testers: negative
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| − | ==Gait Analysis==
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| − | '''A link could be put in here to show you have to perform gait analysis on a horse'''
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| − | * Trot straight line: 2/10 Right Forelimb lame
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| − | * Soft lunge:
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| − | ** right rein: 3/10 Right Forelimb lame
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| − | ** left rein: 2/10 Right Forelimb lame
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| − | * Hard lunge:
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| − | ** right rein: 2/10 RF lame
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| − | ** left rein: no lameness
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| − | * Proximal forelimb flexion, right and left: negative
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| − | * Distal forelimb flexion, right and left: negative
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| − | ==What is your Problem List and Differential List?==
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| − | ===Problem List===
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| − | <font color="white">
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| − | * Pain on palpation
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| − | * Swelling
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| − | * Lameness
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| − | * Thickening of Suspensory Ligament
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| − | </font>
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| − | ===Differential List===
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| − | <font color="white">
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| − | * ?????????
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| − | * ????????
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| − | </font>
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| − | ===What is your revised action plan?===
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| − | <font color="white">
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| − | * Diagnostic Analgesia
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| − | * Radiographs and Ultrasound
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| − | * Scintigraphy
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| − | </font>
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| − | ==Diagnostic Imaging Results==
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| − | ===Ultrasonography===
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| − | '''Could put in the video of the ultrasound in here and also a link on how to perform an ultrasound'''
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| − | Q: What do you think is going?
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| − | A: <font color="white"> There is a focal hypoechoic area on the dorsal border of the suspensory ligament at its proximal insertion </font>
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| − | ===Radiographs===
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| − | '''Put in the actual radiographs and a link on how these radiographs where taken'''
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| − | Q; How would you interpret these radiographs?
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| − | A: <font color="white"> Small radiolucent area with new bone formation on palmar mid aspect of the MC3 of RF. This has questionable significance. </font>
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| − |
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| − | ===Scintigraphy===
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| − | '''Put in the scintigraphy images and a link'''
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| − | Q: How would you interpret these results?
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| − | A: <font color="white"> Mild IRU w/in proximal aspect of left MC2. Mild IRU w/in middle aspect of R MC2 - unlikely to be of clinical significance </font>
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| − | What is your diagnosis?
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| − | <font color="white">
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| − | * '''proximal suspensory ligament desmitis of right forelimb'''
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| − | </font>
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| − | ==Treatment==
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| − | '''Insert a link to different treatments'''
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| − | What do you feel should be done to treat this case?
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| − | This is what actually was done:
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| − | * <font color="white"> Box rest – 2 weeks 15 mins in hand walking BID
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| − | - 2 weeks 30 mins in hand walking BID
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| − | - 2 weeks 40 mins in hand walking BID
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| − | </font>
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| − | [[Category:Lost]]
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